Science.gov

Sample records for 7-day ventilator circuit

  1. A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia

    PubMed Central

    2012-01-01

    Introduction The aim of this study was to compare a 7-day course of doripenem to a 10-day course of imipenem-cilastatin for ventilator-associated pneumonia (VAP) due to Gram-negative bacteria. Methods This was a prospective, double-blinded, randomized trial comparing a fixed 7-day course of doripenem one gram as a four-hour infusion every eight hours with a fixed 10-day course of imipenem-cilastatin one gram as a one-hour infusion every eight hours (April 2008 through June 2011). Results The study was stopped prematurely at the recommendation of the Independent Data Monitoring Committee that was blinded to treatment arm assignment and performed a scheduled review of data which showed signals that were close to the pre-specified stopping limits. The final analyses included 274 randomized patients. The clinical cure rate at the end of therapy (EOT) in the microbiological intent-to-treat (MITT) population was numerically lower for patients in the doripenem arm compared to the imipenem-cilastatin arm (45.6% versus 56.8%; 95% CI, -26.3% to 3.8%). Similarly, the clinical cure rate at EOT was numerically lower for patients with Pseudomonas aeruginosa VAP, the most common Gram-negative pathogen, in the doripenem arm compared to the imipenem-cilastatin arm (41.2% versus 60.0%; 95% CI, -57.2 to 19.5). All cause 28-day mortality in the MITT group was numerically greater for patients in the doripenem arm compared to the imipenem-cilastatin arm (21.5% versus 14.8%; 95% CI, -5.0 to 18.5) and for patients with P. aeruginosa VAP (35.3% versus 0.0%; 95% CI, 12.6 to 58.0). Conclusions Among patients with microbiologically confirmed late-onset VAP, a fixed 7-day course of doripenem was found to have non-significant higher rates of clinical failure and mortality compared to a fixed 10-day course of imipenem-cilastatin. Consideration should be given to treating patients with VAP for more than seven days to optimize clinical outcome. Trial Registration ClinicalTrials.gov: NCT00589693

  2. Open circuit mouthpiece ventilation: Concise clinical review.

    PubMed

    Garuti, G; Nicolini, A; Grecchi, B; Lusuardi, M; Winck, J C; Bach, J R

    2014-01-01

    In 2013 new "mouthpiece ventilation" modes are being introduced to commercially available portable ventilators. Despite this, there is little knowledge of how to use noninvasive intermittent positive pressure ventilation (NIV) as opposed to bi-level positive airway pressure (PAP) and both have almost exclusively been reported to have been used via nasal or oro-nasal interfaces rather than via a simple mouthpiece. Non-invasive ventilation is often reported as failing because of airway secretion encumbrance, because of hypercapnia due to inadequate bi-level PAP settings, or poor interface tolerance. The latter can be caused by factors such as excessive pressure on the face from poor fit, excessive oral air leak, anxiety, claustrophobia, and patient-ventilator dys-synchrony. Thus, the interface plays a crucial role in tolerance and effectiveness. Interfaces that cover the nose and/or nose and mouth (oro-nasal) are the most commonly used but are more likely to cause skin breakdown and claustrophobia. Most associated drawbacks can be avoided by using mouthpiece NIV. Open-circuit mouthpiece NIV is being used by large populations in some centers for daytime ventilatory support and complements nocturnal NIV via "mask" interfaces for nocturnal ventilatory support. Mouthpiece NIV is also being used for sleep with the mouthpiece fixed in place by a lip-covering flange. Small 15 and 22mm angled mouthpieces and straw-type mouthpieces are the most commonly used. NIV via mouthpiece is being used as an effective alternative to ventilatory support via tracheostomy tube (TMV) and is associated with a reduced risk of pneumonias and other respiratory complications. Its use facilitates "air-stacking" to improve cough, speech, and pulmonary compliance, all of which better maintain quality of life for patients with neuromuscular diseases (NMDs) than the invasive alternatives. Considering these benefits and the new availability of mouthpiece ventilator modes, wider knowledge of this

  3. Disposable adult breathing circuits for use with critical care ventilators.

    PubMed

    1994-04-01

    In this issue, we evaluate seven models of disposable breathing circuits from seven manufacturers; the evaluated circuits are intended to be used for adult patients on critical care ventilators. This study is a follow-up to our earlier Evaluation of disposable breathing circuits for use with portable ventilators, published in Health Devices 22(7), July 1993. We based our ratings on the breathing circuits' ability to function properly with minimal intervention from the healthcare provider. We rated only one of the evaluated units Acceptable; this circuit was not likely to interrupt ventilation during normal use (provided that its operation was verified before use). Three of the evaluated breathing circuits were rated Unacceptable because they had disadvantages that were likely to interrupt ventilation during normal use (e.g., a component could accidentally disconnect, the tubing could become kinked or crushed). When such a disadvantage could be compensated for by the healthcare provider, we rated the circuit Conditionally Acceptable: one circuit was rated Conditionally Acceptable; two circuits that had other significant disadvantages were rated Conditionally Acceptable--Not Recommended. We caution readers not to base purchasing decisions on our ratings alone, but on a thorough understanding of the issues surrounding our conclusions, which can be gained by reading this study in its entirety. We offer additional guidance and discuss important selection factors and usage issues in the Selection and Use Guide for Disposable Breathing Circuits included at the end of the Evaluation. Also see "Pre-use Verification of Breathing Circuits" in this issue for step-by-step guidelines to help healthcare providers and caregivers verify proper performance and identify the defective circuits that inevitably reach the clinical setting.

  4. Physiotherapists' attitudes toward circuit class therapy and 7 day per week therapy is influenced by normative beliefs, past experience, and perceived control: A qualitative study.

    PubMed

    Van Kessel, Gisela; Hillier, Susan; English, Coralie

    2017-08-08

    Attitudes are recognized as influencing research implementation. However, little is known about the process by which physiotherapists' attitudes and beliefs shape their use of 7-day per week therapy and circuit class therapy research findings. Understanding beliefs may assist in addressing barriers to research uptake. Fifteen physiotherapists from six rehabilitation centers who ranged in seniority, experience, and education levels consented to be interviewed. The transcribed interviews were analyzed using a qualitative content analysis drawing on the Theory of Planned Behavior. Participants felt that they had autonomy in adopting new approaches when the evidence was supported by social norms. Participants believed that 7-day per week therapy delivers a seamless service that increases physiotherapy time, which helps maintain patient improvement, but needs to accommodate patient choice and expectations. Circuit class therapy was viewed positively as it provides more physiotherapy time, increases patient social interaction, and motivation. However, this was qualified by a belief that patients would not receive individualized, quality of movement focused therapy, particularly for patients with limited capacities. Implementation of a new approach depends on the past experience, coherence with individual beliefs regarding important elements of therapy content, and opportunities to control barriers to implementation.

  5. Circuit class therapy and 7-day-week therapy increase physiotherapy time, but not patient activity: early results from the CIRCIT trial.

    PubMed

    English, Coralie; Bernhardt, Julie; Hillier, Susan

    2014-10-01

    The optimum model of physiotherapy service delivery for maximizing active task practice during rehabilitation after stroke is unknown. The purpose of the study was to examine the relative effectiveness of 2 alternative models of physiotherapy service delivery against a usual care control with regard to increasing patient activity. Substudy within a large 3-armed randomized controlled trial, which compared 3 different models of physiotherapy service delivery, was provided for 4 weeks during subacute, inpatient rehabilitation (n=283). The duration of all physiotherapy sessions was recorded. In addition, 32 participants were observed at 10-minute intervals for 1 weekday and 1 weekend day between 8:00 am and 4:30 pm. At each observation, we recorded physical activity, location, and people present. Participants receiving 7-day-week and circuit class therapy received an additional 3 hours and 22 hours of physiotherapy time, respectively, when compared with usual care. Participants were standing or walking for a median of 8.2% of observations. On weekdays, circuit class therapy participants spent more time in therapy-related activity (10.2% of observations) when compared with usual care participants (6.1% of observations). On weekends, 7-day therapy participants spent more time in therapy-related activity (4.2% of observations) when compared with both usual care and circuit class therapy participants (0% of observations for both groups). Activity levels outside of therapy sessions did not differ between groups. A greater dosage of physiotherapy time did not translate into meaningful increases in physical activity across the day. http://www.anzctr.org.au/. Unique identifier: ACTRN12610000096055. © 2014 American Heart Association, Inc.

  6. Evaluation of a new circuit configuration for the VDR-4 high-frequency percussive ventilator.

    PubMed

    Jones, Samuel W; Short, Kathy A; Hanson, William J; Hendrix, Laura; Charles, Anthony G; Cairns, Bruce A

    2010-01-01

    High-frequency percussive ventilation (HFPV) by the VDR-4(R) has been a successful mode of ventilation in the management of inhalation injuries for nearly 20 years. A limitation of the standard VDR-4 ventilator circuit is that the sliding venturi manifold is heavy in weight and is normally connected directly to the patient's endotracheal tube (ETT), resulting in potentially hazardous torque on the ETT. In this study, we evaluate the mechanics of a new circuit for the VDR-4 that relocates the sliding venturi manifold portion of the circuit away from the ETT into the ventilator proper. This new VDR-4 circuit configuration may have an important impact on patient safety.

  7. Impact of adding a filter for protection from toxic inhalational compounds to the ventilation circuit of mechanically ventilated patients.

    PubMed

    Be'eri, Eliezer; Owen, Simon; Shachar, Mark; Barlavie, Yaron; Eisenkraft, Arik

    2016-01-01

    Standard-issue Chemical-Biological-Radio-Nuclear (CBRN) gasmasks, as used for protection from non-conventional warfare agents or toxic industrial compounds, cannot be used by ventilated patients, leaving them exposed to toxic agents inhaled via their ventilators. This study was conducted to determine the safety of a CBRN filter added to the patient circuit of a ventilator, as a method for affording inhalational protection to ventilated patients. A Landrace pig was ventilated sequentially with 3 types of ventilators according to 17 different ventilation protocols, with and without a CBRN filters added in-line to the ventilation tubing for each protocol. For each protocol, physiological parameters, including oxygen saturation, inspired CO2, end tidal CO2, inspired oxygen, respiratory rate, and pulse rate, as well as airflow parameters including peak inspiratory pressure, positive end expiratory pressure and tidal volume were measured. The impact on the ventilator's trigger/sensitivity function was evaluated in vitro using a Michigan test lung. On average, the addition of the CBRN filter resulted in a 16 ml (5 %) decrease (range 0-50 ml) in the tidal volume, a 1.7 cm H2O (10 %) decrease (range 1-3 cm H2O) in the peak inspiratory pressure, and a 0.1 cm H2O (3 %) decrease (range 0-1 cm H2O) in the positive end expiratory pressure delivered to the animal. Some ventilators compensated for these airflow changes while others did not, depending on the design of the ventilator's pressure/flow sensing mechanism. Significant rebreathing occurred when the filter was positioned directly on the animal's endotracheal tube, but not when positioned on the air outflow port of the ventilator. In vitro measurements showed that the addition of the CBRN filter added a mean pressure gradient of 0.45 cm H2O to the trigger/sensitivity function of the system. In-line addition of a CBRN filter to ventilation tubing is a feasible strategy for affording inhalational protection to

  8. Re-inspiration of CO2 from ventilator circuit: effects of circuit flushing and aspiration of dead space up to high respiratory rate

    PubMed Central

    2010-01-01

    Introduction Dead space negatively influences carbon dioxide (CO2) elimination, particularly at high respiratory rates (RR) used at low tidal volume ventilation in acute respiratory distress syndrome (ARDS). Aspiration of dead space (ASPIDS), a known method for dead space reduction, comprises two mechanisms activated during late expiration: aspiration of gas from the tip of the tracheal tube and gas injection through the inspiratory line - circuit flushing. The objective was to study the efficiency of circuit flushing alone and of ASPIDS at wide combinations of RR and tidal volume (VT) in anaesthetized pigs. The hypothesis was tested that circuit flushing and ASPIDS are particularly efficient at high RR. Methods In Part 1 of the study, RR and VT were, with a computer-controlled ventilator, modified for one breath at a time without changing minute ventilation. Proximal dead space in a y-piece and ventilator tubing (VDaw, prox) was measured. In part two, changes in CO2 partial pressure (PaCO2) during prolonged periods of circuit flushing and ASPIDS were studied at RR 20, 40 and 60 minutes-1. Results In Part 1, VDaw, prox was 7.6 ± 0.5% of VT at RR 10 minutes-1 and 16 ± 2.5% at RR 60 minutes-1. In Part 2, circuit flushing reduced PaCO2 by 20% at RR 40 minutes-1 and by 26% at RR 60 minutes-1. ASPIDS reduced PaCO2 by 33% at RR 40 minutes-1 and by 41% at RR 60 minutes-1. Conclusions At high RR, re-breathing of CO2 from the y-piece and tubing becomes important. Circuit flushing and ASPIDS, which significantly reduce tubing dead space and PaCO2, merit further clinical studies. PMID:20420671

  9. Anaesthesia ventilators

    PubMed Central

    Jain, Rajnish K; Swaminathan, Srinivasan

    2013-01-01

    Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters. Modern anaesthesia ventilators have either a double circuit, bellow design or a single circuit piston configuration. In the bellows ventilators, ascending bellows design is safer than descending bellows. Piston ventilators have the advantage of delivering accurate tidal volume. They work with electricity as their driving force and do not require a driving gas. To enable improved patient safety, several modifications were done in circle system with the different types of anaesthesia ventilators. Fresh gas decoupling is a modification done in piston ventilators and in descending bellows ventilator to reduce th incidence of ventilator induced volutrauma. In addition to the conventional volume control mode, modern anaesthesia ventilators also provide newer modes of ventilation such as synchronised intermittent mandatory ventilation, pressure-control ventilation and pressure-support ventilation (PSV). PSV mode is particularly useful for patients maintained on spontaneous respiration with laryngeal mask airway. Along with the innumerable benefits provided by these machines, there are various inherent hazards associated with the use of the ventilators in the operating room. To use these workstations safely, it is important for every Anaesthesiologist to have a basic understanding of the mechanics of these ventilators and breathing circuits. PMID:24249886

  10. Ventilation.

    PubMed

    Turner, W A; Bearg, D W; Brennan, T

    1995-01-01

    This chapter begins with an overview of the history of ventilation guidelines, which has led to the guidelines that are in effect today. Of particular interest is the most recent return in the past 5 years to ventilation rates that more closely reflect a mean or average of the range of guidelines that have existed over the past century. OSHA's and the EPA's recognition of the need to operate ventilation systems in buildings in an accountable manner is also of note. Of even more interest is the resurgence of the concept of minimum mixing and once-through ventilation air that has been pursued in parts of Northern Europe for the past 10 years, and in a school that is being designed with this concept in New Hampshire. In addition, the design concept of equipping office buildings with low pressure drop high efficiency particle filtration to remove fine particles from all of the air that is supplied to the occupants is being used increasingly in the U.S. This chapter also presents an overview of the various types of ventilation systems found in homes and commercial office buildings and the common indoor air quality problems that may be associated with them. It also offers an overview of common HVAC evaluation techniques that can be used to determine if a ventilation system is performing in a manner that makes sense for the use of the space and the needs of the occupants. Are the occupants receiving a reasonable supply of outdoor air? Is the air that they receive of reasonable quality? Are obvious pollutants being exhausted? Ventilation systems have become extremely complex and more difficult to run and maintain over the past 40 years. This trend will continue to drive the need for professionally maintained HVAC equipment that is serviced and run by individuals who are accountable for the quality of the air that the system delivers.

  11. Dangerous Pressurization and Inappropriate Alarms during Water Occlusion of the Expiratory Circuit of Commonly Used Infant Ventilators

    PubMed Central

    Perdomo, Aldo

    2016-01-01

    Background Non-invasive continuous positive airways pressure is commonly a primary respiratory therapy delivered via multi-purpose ventilators in premature newborns. Expiratory limb occlusion due to water accumulation or ‘rainout’ from gas humidification is a frequent issue. A case of expiratory limb occlusion due to rainout causing unexpected and excessive repetitive airway pressurisation in a Draeger VN500 prompted a systematic bench test examination of currently available ventilators. Objective To assess neonatal ventilator response to partial or complete expiratory limb occlusion when set to non-invasive continuous positive airway pressure mode. Design Seven commercially available neonatal ventilators connected to a test lung using a standard infant humidifier circuit with partial and/or complete expiratory limb occlusion were examined in a bench test study. Each ventilator was set to deliver 6 cmH2O in non-invasive mode and respiratory mechanics data for 75%, 80% and 100% occlusion were collected. Results Several ventilators responded inappropriately with complete occlusion by cyclical pressurisation/depressurisation to peak pressures of between 19·4 and 64·6 cm H2O at rates varying between 2 to 77 inflations per minute. Tidal volumes varied between 10·1 and 24·3mL. Alarm responses varied from ‘specific’ (tube occluded) to ‘ambiguous’ (Safety valve open). Carefusion Avea responded by continuing to provide the set distending pressure and displaying an appropriate alarm message. Draeger Babylog 8000 did not alarm with partial occlusions and incorrectly displayed airways pressure at 6·1cmH2O compared to the measured values of 13cmH2O. Conclusions This study found a potential for significant adverse ventilator response due to complete or near complete expiratory limb occlusion in CPAP mode. PMID:27116224

  12. Comparison of three humidifiers during high-frequency percussive ventilation using the VDR-4® Fail-safe Breathing Circuit Hub.

    PubMed

    Tiffin, Norman H; Short, Kathy A; Jones, Samuel W; Cairns, Bruce A

    2011-01-01

    The VDR-4® high-frequency percussive ventilator (HFPV) has been shown to be beneficial in the management of inhalation injury by improving secretion clearance while maintaining oxygenation and ventilation. Delivery of gas flow during HFPV could lack adequate humidification delivered to the patient because a major portion of the delivered gas flow would bypass the humidifier when using the original VDR-4® ventilator circuit. The authors tested a novel inline vaporizing humidifier and two gas-water interface humidifiers during HFPV using the new VDR-4® Fail-safe Breathing Circuit Hub® to determine whether delivered humidification could be improved. This new humidification system, the Hydrate Omni™, delivers water vapor into the gas flow of the ventilator circuit rather than water droplets as delivered by the gas-water interface humidifiers. Measurements of absolute humidity and gas temperature were made on the three different humidification systems using a test lung model under standard ambient conditions. The authors found that when using the novel inline vaporizer, it provided better humidification when compared with the standard gas-water interface humidifier during HFPV using the new VDR-4® breathing circuit.

  13. [Efficiency of novel splash-proof ventilator circuit component on VAP and the colonization of multiple-drug resistant bacteria prevention in patients undergoing mechanical ventilation: a prospective randomized controlled intervention study with 318 patients].

    PubMed

    Xu, Songao; Yu, Huijie; Sun, Hui; Zhu, Xiangyun; Xu, Xiaoqin; Xu, Jun; Cao, Weizhong

    2017-01-01

    To investigate the efficiency of closed tracheal suction system (CTSS) using novel splash-proof ventilator circuit component on ventilator-associated pneumonia (VAP) and the colonization of multiple-drug resistant bacteria (MDR) in patients undergoing mechanical ventilation (MV) prevention. A prospective single-blinded randomized parallel controlled intervention study was conducted. 330 severe patients admitted to the intensive care unit (ICU) of the First Hospital of Jiaxing from January 2014 to May 2016 were enrolled, and they were divided into open tracheal suction group, closed tracheal suction group, and splash-proof suction group on average by random number table. The patients in the three groups used conventional ventilator circuit component, conventional CTSS, and CTSS with a novel splash-proof ventilator circuit component for MV and sputum suction, respectively. The incidence of VAP, airway bacterial colonization rate, MDR and fungi colonization rate, duration of MV, length of ICU and hospitalization stay, and financial expenditure during hospitalization, as well as the in-hospital prognosis were recorded. After excluding patients who did not meet the inclusion criteria, incomplete data, backed out and so on, 318 patients were enrolled in the analysis finally. Compared with the open tracheal suction group, the total incidence of VAP was decreased in the closed tracheal suction group and splash-proof suction group [20.95% (22/105), 21.90% (23/105) vs. 29.63% (32/108)], but no statistical difference was found (both P > 0.05), and the incidence of VAP infections/1 000 MV days showed the same change tendency (cases: 14.56, 17.35 vs. 23.07). The rate of airway bacterial colonization and the rate of MDR colonization in the open tracheal suction group and splash-proof suction group were remarkably lower than those of closed tracheal suction group [32.41% (35/108), 28.57% (30/105) vs. 46.67% (49/105), 20.37% (22/108), 15.24% (16/105) vs. 39.05% (41/105)] with

  14. Ventilator waveforms.

    PubMed

    Mellema, Matthew S

    2013-08-01

    Ventilator waveforms are graphic representations of changes in pressure, flow, and volume within a ventilator circuit. The changes in these parameters over time may be displayed individually (scalars) or plotted one against another (pressure-volume and flow-volume loops). There are 6 basic shapes of scalar waveforms, but only 3 are functionally distinct (square, ramp, and sine). The pressure scalar is a particularly valuable tool when constant flow (e.g., volume control) modes are employed and an inspiratory pause is added. In this setting, inspection of the pressure waveform can allow determination of static, quasistatic, and dynamic compliance, as well as relative changes in airway resistance. Inspection of the pressure waveform can also help to identify many important aspects of patient drug responses, dyssynchrony, and air trapping (auto positive end-expiratory pressure [auto-PEEP]). Depending on the ventilation mode employed, the shape of the flow waveform may be set by the ventilator operator or may be dependent on patient effort and lung mechanics. Decelerating flow patterns have several important advantages when this option is available. Inspection of flow waveforms is crucial in the recognition of dyssynchrony, setting optimal inspiratory times, evaluating responses to bronchodilators, and the recognition of auto-PEEP. The volume waveform often contains somewhat less useful information than the other 2 scalars, but plays a crucial role in the identification of leaks in the circuit. Pressure-volume loops are particularly useful in setting PEEP and peak inspiratory pressure ranges. Inspection of these loops also often helps in the evaluation of lung mechanics, in the identification of circuit leaks, and in the assessment of patient triggering effort. Flow-volume loops are extremely useful in the identification of leaks and excessive airway secretions as well as alterations in airway resistance. Lastly, serial waveform inspection is crucial to the

  15. Fuel utilization during exercise after 7 days of bed rest

    NASA Technical Reports Server (NTRS)

    Barrows, Linda H.; Harris, Bernard A.; Moore, Alan D.; Siconolfi, Steven F.

    1992-01-01

    Energy yield from carbohydrate, fat, and protein during physical activity is partially dependent on an individual's fitness level. Prolonged exposure to microgravity causes musculoskeletal and cardiovascular deconditioning; these adaptations may alter fuel utilization during space flight. Carbohydrate and fat metabolism during exercise were analyzed before and after 7 days of horizontal bed rest.

  16. Mechanical ventilation with heated humidifiers: measurements of condensed water mass within the breathing circuit according to ventilatory settings.

    PubMed

    Schena, E; Saccomandi, P; Cappelli, S; Silvestri, S

    2013-07-01

    Heated wire humidifiers (HWHs) are widely used to heat and humidify gases during mechanical ventilation. The control strategy implemented on commercial HWHs, based on maintaining constant gas temperature at the chamber outlet, shows weaknesses: humidifying performances depend on environmental temperature and ventilatory settings, and often condensation occurs. Herein, we analyzed in vitro HWH performances focusing on the condensation amount according to ventilatory settings. We used a physical model to define the parameters which mainly influence the HWH performances. In order to investigate the influence of minute volume (MV) and frequency rate (fr) on condensation, the other influencing parameters were kept constant during experiments, and we introduced a novel approach to estimate the condensation. The method, based on measuring the condensed vapor mass (Δm), provided more objective information than the visual-based scale used in previous studies. Thanks to both the control of other influencing factors and the accurate Δm measures, the investigation showed the Δm increase with MV and fr. Substantial condensation after 7 h of ventilation and the influence of MV and fr on Δm (i.e., Δm = 3 g at MV = 1.5 L min(-1) and fr = 8 bpm and Δm = 9.4 g at MV = 8 L min(-1) and fr = 20 bpm) confirm the weaknesses of `single-point temperature' control strategies.

  17. IR Camera Report for the 7 Day Production Test

    SciTech Connect

    Holloway, Michael Andrew

    2016-02-22

    The following report gives a summary of the IR camera performance results and data for the 7 day production run that occurred from 10 Sep 2015 thru 16 Sep 2015. During this production run our goal was to see how well the camera performed its task of monitoring the target window temperature with our improved alignment procedure and emissivity measurements. We also wanted to see if the increased shielding would be effective in protecting the camera from damage and failure.

  18. Ventilation and ventilators.

    PubMed

    Hayes, B

    1982-01-01

    The history of ventilation is reviewed briefly and recent developments in techniques of ventilation are discussed. Operating features of ventilators have changed in the past few years, partly as the result of clinical progress; yet, technology appears to have outstripped the clinician's ability to harness it most effectively. Clinical discipline and training of medical staff in the use of ventilators could be improved. The future is promising if clinician and designer can work together closely. Ergonomics of ventilators and their controls and the provision of alarms need special attention. Microprocessors are likely to feature prominently in the next generation of designs.

  19. Physiological Effects of Positive Pressure Ventilation.

    DTIC Science & Technology

    1992-05-01

    in the ventilated patient and increase proportionally with the length of time Ventilation 43 mechanical ventilation is employed. Major infection ... sources are contributed to repeated breaks in the ventilator circuit and aspiration of gastric contents. There appears to be a positive correlation with

  20. Modelling of in-vitro and in-vivo performance of aerosol emitted from different vibrating mesh nebulisers in non-invasive ventilation circuit.

    PubMed

    Rabea, Hoda; Ali, Ahmed M A; Salah Eldin, Randa; Abdelrahman, Maha M; Said, Amira S A; Abdelrahim, Mohamed E

    2017-01-15

    Substituting nebulisers by another in non-invasive ventilation circuit (NIV) involves many process variables which must be adjusted to ensure patient optimum therapy. However, there is a doubt when nebulisers use the same technology. Data mining technology based on artificial neural networks and genetic algorithms were used here to model in-vitro inhalation process and predict bioavailability from inhaled doses delivered by three different vibrating mesh nebulisers (VMNs) in NIV. Modelling of data indicated that in-vitro performance of VMNs was dependent mainly on fine particle fraction, mass median aerodynamic diameter (MMAD), total emitted dose (TED) and to lesser extent on nebuliser type. Ex-vivo model indicated that amount of salbutamol collected on facemask filter was directly affected by TED. In-vivo model showed that amount of salbutamol deposited into the lung (0.5hQ) and amount absorbed systemically (24hQ) were dependent directly on MMAD and TED. Female patients showed higher 24hQ values than males. Nebuliser type affected TED, 0.5hQ but not 24hQ values. Results indicate suitability of VMNs in achieving appropriate in-vitro inhalation performance model. The results also, indicate that the three VMNs are comparable and can be interchanged with no fear of any additional toxicity.

  1. 7000 miles and 7 days from the battlefield.

    PubMed

    McNeill, Margaret M

    2010-01-01

    Critically injured combat casualties are rapidly evacuated from the battlefield, and within hours of their injuries they begin a 7000-mile journey home, often arriving in the United States within 7 days. National Naval Medical Center in Bethesda, Maryland, is a major facility for wounded warrior care in the Military Health System. Throughout the facility, the staff from a variety of disciplines and all military services provides care for military personnel with injuries and illnesses, with the goal of optimizing recovery and quality of life. The foundational evidence for select aspects of this care is discussed. Innovations in training and care delivery include the Air Force Nurse Corps' Critical Care Fellowship, the new inpatient Traumatic Brain Injury Unit, and the National Intrepid Center for Excellence for Traumatic Brain Injury and Psychological Health. The future of the Medical Center includes a new name, expanded staff, and newly constructed space by Department of Defense Base Realignment and Closure activities.

  2. Skin Microcirculatory Dysfunction Induced by 7 Days of Dry Immersion

    NASA Astrophysics Data System (ADS)

    Navasiolava, N. M.; Tsvirkun, D. V.; Pastushkova, L. Kh.; Larina, I. M.; Dobrokhotov, I. V.; Fortrat, J. O.; Gharib, G.; Gauquelin-Koch, G.; Custaud, M.-A.

    2008-06-01

    To study the effects of microgravity on the skin microcirculatory function, basal blood flow and stimulated vasodilation were determined at the calf level by laser Doppler flowmetry in 8 male subjects before, during and after 7 days of dry immersion. Endothelium-dependent and - independent vasodilation was assessed using iontophoresis of acetylcholine and sodium nitroprusside, respectively. Basal blood flow was significantly reduced on the third day of immersion (13 ± 1 arbitrary units (AU) vs. 33 ± 8 AU pre-immersion level, p < 0.05) and rested decreased up to the end of immersion. Endothelium dependent vasodilation was significantly decreased on the seventh day of immersion in comparison with pre-immersion values (12 ± 6% vs. 29 ± 6% of max vasodilation, p < 0.05). Our results support the idea that dry immersion induces changes in skin microcirculation with impairment of endothelial functions. Microcirculatory impairment should be considered as an important factor of the cardiovascular deconditioning.

  3. Mortality after surgery in Europe: a 7 day cohort study.

    PubMed

    Pearse, Rupert M; Moreno, Rui P; Bauer, Peter; Pelosi, Paolo; Metnitz, Philipp; Spies, Claudia; Vallet, Benoit; Vincent, Jean-Louis; Hoeft, Andreas; Rhodes, Andrew

    2012-09-22

    Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe. We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ(2) and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries. We included 46,539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9-3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0-3·0] for Iceland to 21·5% [16·9-26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19-1·05; p=0·06] for Finland to 6·92 [2·37-20·27; p=0·0004] for Poland). The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care

  4. Assisted Ventilation.

    PubMed

    Dries, David J

    2016-01-01

    Controlled Mechanical Ventilation may be essential in the setting of severe respiratory failure but consequences to the patient including increased use of sedation and neuromuscular blockade may contribute to delirium, atelectasis, and diaphragm dysfunction. Assisted ventilation allows spontaneous breathing activity to restore physiological displacement of the diaphragm and recruit better perfused lung regions. Pressure Support Ventilation is the most frequently used mode of assisted mechanical ventilation. However, this mode continues to provide a monotonous pattern of support for respiration which is normally a dynamic process. Noisy Pressure Support Ventilation where tidal volume is varied randomly by the ventilator may improve ventilation and perfusion matching but the degree of support is still determined by the ventilator. Two more recent modes of ventilation, Proportional Assist Ventilation and Neurally Adjusted Ventilatory Assist (NAVA), allow patient determination of the pattern and depth of ventilation. Proposed advantages of Proportional Assist Ventilation and NAVA include decrease in patient ventilator asynchrony and improved adaptation of ventilator support to changing patient demand. Work of breathing can be normalized with these modes as well. To date, however, a clear pattern of clinical benefit has not been demonstrated. Existing challenges for both of the newer assist modes include monitoring patients with dynamic hyperinflation (auto-positive end expiratory pressure), obstructive lung disease, and air leaks in the ventilator system. NAVA is dependent on consistent transduction of diaphragm activity by an electrode system placed in the esophagus. Longevity of effective support with this technique is unclear.

  5. Inspiratory work and response times of a modified pediatric volume ventilator during synchronized intermittent mandatory ventilation and pressure support ventilation.

    PubMed

    Martin, L D; Rafferty, J F; Wetzel, R C; Gioia, F R

    1989-12-01

    Volume ventilation by demand flow ventilators significantly increases work of breathing during inspiration. Although various ventilator modifications and different modes of ventilation have been developed, there have been few studies regarding imposed work of breathing in infants and children. This study was designed to evaluate several modifications of a commercially available demand flow ventilator designed to shorten response time (tr) and decrease the imposed work (Wi) involved in opening the demand valve. Minimum withdrawal volume (Vmin), maximum negative pressure (P mneg), and tr were measured. Wi was defined as the product of Vmin and P mneg. Seven Siemens Servo 900C ventilators were tested under 16 different trial conditions with four variables: 1) mode of ventilation (synchronized intermittent mandatory ventilation [SIMV] vs. pressure support ventilation [PSV]); 2) caliber of circuit tubing (adult vs. pediatric); 3) location of airway pressure monitor (distal vs. proximal); and 4) ventilator trigger sensitivity (0 cm H2O--high vs. -2 cm H2O--low). Vmin, Pmneg, and Wi were all decreased (P less than .05) while tr was unaffected by changing ventilator trigger sensitivity from low to high. Wi was decreased by pediatric tubing and proximal airway pressure monitoring only when low trigger sensitivity was used. PSV and proximal airway monitoring shortened tr. The authors conclude that the use of pediatric circuit tubing and proximal airway pressure monitoring with a Siemens Servo 900C ventilator significantly improved ventilator performance.

  6. Short treatment durations for acute bacterial rhinosinusitis: Five days of gemifloxacin versus 7 days of gemifloxacin.

    PubMed

    Ferguson, Berrylin J; Anon, Jack; Poole, Michael D; Hendrick, Kim; Gilson, Martyn; Seltzer, Elyse G

    2002-07-01

    The primary objective of this study was to demonstrate the clinical and radiologic efficacy of 5 days compared with 7 days of gemifloxacin therapy in the treatment of acute bacterial rhinosinusitis (ABRS). In this prospective, double-blind, multicenter, parallel-group study, adult patients presenting with ABRS were randomized to receive gemifloxacin 320 mg once daily for either 5 days (n = 218) or 7 days (n = 203). For the primary efficacy end point, clinical response to therapy at follow-up, 5 days of therapy with gemifloxacin was as effective as 7 days of therapy (per-protocol population; treatment difference 0.44%; 95% confidence interval [CI], -6.54 to 7.41). Five and 7 days of treatment with gemifloxacin were well tolerated. The clinical efficacy of gemifloxacin 320 mg daily for 5 days is at least as good as the efficacy of gemifloxacin 320 mg daily for 7 days in the treatment of ABRS.

  7. Inhalation therapy in mechanical ventilation

    PubMed Central

    Maccari, Juçara Gasparetto; Teixeira, Cassiano; Gazzana, Marcelo Basso; Savi, Augusto; Dexheimer-Neto, Felippe Leopoldo; Knorst, Marli Maria

    2015-01-01

    Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients. PMID:26578139

  8. Difficult weaning from mechanical ventilation.

    PubMed

    Oh, T E

    1994-07-01

    Weaning from mechanical ventilation may be influenced by factors relating to equipment, techniques and procedures. Criteria to initiate weaning and predictors of weaning outcome are generally unreliable, but mechanical work of breathing, the tidal volume: frequency ratio and the inspiratory pressure: maximal inspiratory pressure ratio may anticipate those likely to fail weaning. The optimal weaning ventilatory mode is not known, but intermittent mandatory ventilation, pressure support ventilation, and continuous positive pressure ventilation are the most commonly used. The resistances of individual components of breathing circuits are extremely important. Blow-by heated humidifiers and ventilators which compensate for the impedances of their inspiratory demand valves impose clinically acceptable spontaneous breathing loads. Close monitoring, adequate respiratory muscle rest, attention to mineral deficiencies, nutrition and pulmonary hygiene are also important parts of the weaning process.

  9. Demand Controlled Ventilation and Classroom Ventilation

    SciTech Connect

    Fisk, William J.; Mendell, Mark J.; Davies, Molly; Eliseeva, Ekaterina; Faulkner, David; Hong, Tienzen; Sullivan, Douglas P.

    2012-05-01

    This document summarizes a research effort on demand controlled ventilation and classroom ventilation. The research on demand controlled ventilation included field studies and building energy modeling.

  10. Do new anesthesia ventilators deliver small tidal volumes accurately during volume-controlled ventilation?

    PubMed

    Bachiller, Patricia R; McDonough, Joseph M; Feldman, Jeffrey M

    2008-05-01

    During mechanical ventilation of infants and neonates, small changes in tidal volume may lead to hypo- or hyperventilation, barotrauma, or volutrauma. Partly because breathing circuit compliance and fresh gas flow affect tidal volume delivery by traditional anesthesia ventilators in volume-controlled ventilation (VCV) mode, pressure-controlled ventilation (PCV) using a circle breathing system has become a common approach to minimizing the risk of mechanical ventilation for small patients, although delivered tidal volume is not assured during PCV. A new generation of anesthesia machine ventilators addresses the problems of VCV by adjusting for fresh gas flow and for the compliance of the breathing circuit. In this study, we evaluated the accuracy of new anesthesia ventilators to deliver small tidal volumes. Four anesthesia ventilator systems were evaluated to determine the accuracy of volume delivery to the airway during VCV at tidal volume settings of 100, 200, and 500 mL under different conditions of breathing circuit compliance (fully extended and fully contracted circuits) and lung compliance. A mechanical test lung (adult and infant) was used to simulate lung compliances ranging from 0.0025 to 0.03 L/cm H(2)O. Volumes and pressures were measured using a calibrated screen pneumotachograph and custom software. We tested the Smartvent 7900, Avance, and Aisys anesthesia ventilator systems (GE Healthcare, Madison, WI) and the Apollo anesthesia ventilator (Draeger Medical, Telford, PA). The Smartvent 7900 and Avance ventilators use inspiratory flow sensors to control the volume delivered, whereas the Aisys and Apollo ventilators compensate for the compliance of the circuit. We found that the anesthesia ventilators that use compliance compensation (Aisys and Apollo) accurately delivered both large and small tidal volumes to the airway of the test lung under conditions of normal and low lung compliance during VCV (ranging from 95.5% to 106.2% of the set tidal volume

  11. A 7-day recall period for a clinical application of the Oral Health Impact Profile questionnaire

    PubMed Central

    Waller, Niels; John, Mike T.; Feuerstahler, Leah; Baba, Kazuyoshi; Larsson, Pernilla; Peršič, Sanja; Kende, Dóra; Reißmann, Daniel R.; Rener-Sitar, Ksenija

    2015-01-01

    Objectives Aims were to investigate and compare the validity and reliability of Oral Health Impact Profile (OHIP) scores referencing 7-day and one-month recall periods in international prosthodontic patients. Material and Methods A sample of 267 patients (mean age = 54.0 years, SD = 17.2 years, 58% women) with stable oral health-related quality of life was recruited from prosthodontic treatment centers in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden. These patients completed the OHIP on two occasions using a new 7-day recall period and the traditional one-month recall period. OHIP score validity and reliability were investigated with structural equation models (SEMs) that included OHIPpast 7 days and OHIPone-month latent factors and single indicator measures of global oral health status. The SEMs assessed measurement invariance and the relative validities of the two OHIP latent factors (representing the two recall periods). Results The SEMs provided cogent evidence for recall period measurement invariance for the two OHIP forms and equal validities (r = .48) with external measures of global oral health status. Conclusion When assessed in international prosthodontic patients, OHIP scores using the new 7-day recall period were as reliable and valid as the scores using the one-month recall period. Clinical relevance Conceptual advantages make a 7-day recall period a preferred frame of reference in clinical applications of the OHIP questionnaire. PMID:25944561

  12. Ventilation Model

    SciTech Connect

    V. Chipman

    2002-10-05

    The purpose of the Ventilation Model is to simulate the heat transfer processes in and around waste emplacement drifts during periods of forced ventilation. The model evaluates the effects of emplacement drift ventilation on the thermal conditions in the emplacement drifts and surrounding rock mass, and calculates the heat removal by ventilation as a measure of the viability of ventilation to delay the onset of peak repository temperature and reduce its magnitude. The heat removal by ventilation is temporally and spatially dependent, and is expressed as the fraction of heat carried away by the ventilation air compared to the fraction of heat produced by radionuclide decay. One minus the heat removal is called the wall heat fraction, or the remaining amount of heat that is transferred via conduction to the surrounding rock mass. Downstream models, such as the ''Multiscale Thermohydrologic Model'' (BSC 2001), use the wall heat fractions as outputted from the Ventilation Model to initialize their post-closure analyses. The Ventilation Model report was initially developed to analyze the effects of preclosure continuous ventilation in the Engineered Barrier System (EBS) emplacement drifts, and to provide heat removal data to support EBS design. Revision 00 of the Ventilation Model included documentation of the modeling results from the ANSYS-based heat transfer model. The purposes of Revision 01 of the Ventilation Model are: (1) To validate the conceptual model for preclosure ventilation of emplacement drifts and verify its numerical application in accordance with new procedural requirements as outlined in AP-SIII-10Q, Models (Section 7.0). (2) To satisfy technical issues posed in KTI agreement RDTME 3.14 (Reamer and Williams 2001a). Specifically to demonstrate, with respect to the ANSYS ventilation model, the adequacy of the discretization (Section 6.2.3.1), and the downstream applicability of the model results (i.e. wall heat fractions) to initialize post

  13. Ventilator-associated pneumonia.

    PubMed

    2009-11-01

    Ventilator-associated pneumonia is a pneumonia that develops initially more than 48 h from the start of tracheal intubation and mechanical ventilation. The route of infection is almost always through the respiratory tract. Intake of contaminants from outside the tracheal tube (silent aspiration) is considered a key route, and suctioning of secretions that have accumulated above the cuff of the endotracheal tubes is effective in preventing infection. The circuit is managed and heated-wire humidifiers and suction are manipulated based on appropriate infection control measures. To diagnose pathogens, efforts should be made to collect specimens from the pneumonia focus. Realistically, however, diagnosis can also be achieved based on the clinical course and from the results of culture of samples from tracheal aspirate. Use of prophylactic antimicrobials is not recommended, but once a diagnosis is made, antimicrobials are administered that combat the causative microorganism.

  14. Comparing the 7-Day PAR with a Triaxial Accelerometer for Measuring Time in Exercise

    PubMed Central

    Sloane, Richard; Snyder, Denise Clutter; Demark-Wahnefried, Wendy; Lobach, David; Kraus, William E.

    2009-01-01

    Purpose The primary study aim was to evaluate associations of estimated weekly minutes of moderate-to-vigorous intensity exercise from self-reports of the telephone-administered 7-Day Physical Activity Recall (PAR) with data captured by the RT3 triaxial accelerometer. Methods This investigation was undertaken as part of the FRESH START study, a randomized clinical trial that tested an iteratively-tailored diet and exercise mailed print intervention among newly diagnosed breast and prostate cancer survivors. A convenience sample of 139 medically-eligible subjects living within a 60-mile radius of the study center provided both 7-Day PAR and accelerometer data at enrollment. Ultimately n=115 substudy subjects were found eligible for the FRESH START study and randomized to one of two study treatment arms. Follow-up assessments at Year 1 (n=103) and Year 2 (n=99) provided both the 7-Day PAR and accelerometer data. Results There was moderate agreement between the 7-Day PAR and the accelerometer with longitudinal serial correlation coefficients of .54 (baseline), .24 (Year 1) and .53 (Year 2), all P-values < .01, though the accelerometer estimates for weekly time in moderate-to-vigorous physical activity were much higher than those of the 7-Day PAR at all time points. The two methods were poorly correlated in assessing sensitivity to change from baseline to Year 1 (rho=.11, P=.30). Using mixed models repeated measures analysis, both methods exhibited similar non-significant treatment arm X time interaction P-values (7-Day PAR=.22, accelerometer=.23). Conclusions The correlations for three serial time points were in agreement with findings of other studies that compared self-reported time in exercise with physical activity captured by accelerometry. However, these methods capture somewhat different dimensions of physical activity and provide differing estimates of change over time. PMID:19461530

  15. Mechanical Ventilation

    MedlinePlus

    ... cared for in a hospital’s intensive care unit (ICU). People who need a ventilator for a longer time may be in a regular unit of a hospital, a rehabilitation facility, or cared for at home. Why are ...

  16. Estimates of 7-day, 10-year minimum flows at selected stream sites in Puerto Rico

    USGS Publications Warehouse

    Cobb, Ernest D.

    1978-01-01

    The 7-day, 10-year minimum flow of streams is used as an index for determining the capacity of streams to receive waste effluents. This index of flow was computed from streamflow records for 31 stream sites in Puerto Rico. In addition, there was a need for the 7-day, 10-year minimum flow at an additional 15 stream sites for which adequate streamflow data were not available. The flow index was estimated at these sites on the basis of available record, records at nearby sites, and comparisons with drainage areas. (Woodard-USGS)

  17. [Leak monitoring in noninvasive ventilation].

    PubMed

    Rabec, C A; Reybet-Degat, O; Bonniaud, P; Fanton, A; Camus, P

    2004-11-01

    Nasal mask ventilation has been shown to be effective, but outcomes do not always match expectations because of mouth leaks, patient-ventilator asynchrony, or decreased upper airway patency. These developments are detected when they lead ultimately to circuit leaks that lower the effectiveness of ventilation through pressure loss, poor inspiratory triggering, and prolonged inspiratory time. The quality of sleep is affected, and adverse effects and treatment intolerance may arise. A number of ways to detect leaks and their practical consequences are proposed in this article. We applied 310 leak-detection procedures to 177 patients who had disappointing clinical, gasometric, or polysomnographic outcomes of ventilation. The leak-detection procedures varied according to the type of ventilation and the supposed underlying pathophysiological mechanism. Significant leaks were detected in 132 patients (76%); therapeutic changes were then prescribed to optimize outcomes. We present a practical method to apply in patients with suboptimal ventilation outcomes. If leaks can be detected during treatment, the probable cause of treatment failure can sometimes be established and possible pathophysiological mechanisms better understood. With this knowledge, it may be possible to improve ventilation.

  18. 29 CFR 2530.200b-7 - Day of service for employees in the maritime industry.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Day of service for employees in the maritime industry. 2530... BENEFIT PLANS Scope and General Provisions § 2530.200b-7 Day of service for employees in the maritime industry. (a) General rule. A day of service in the maritime industry which must, as a minimum, be...

  19. Treating acute urinary tract infections. An RCT of 3-day versus 7-day norfloxacin.

    PubMed Central

    Trienekens, T. A.; London, N. H.; Houben, A. W.; De Jong, R. A.; Stobberingh, E. E.

    1993-01-01

    A randomized, controlled trial was carried out to compare two courses of treatment in women with acute urinary tract infection in general practice. The 3-day course of treatment was found to be as effective as, and cheaper than, the 7-day therapy. PMID:8471899

  20. Prospective randomized controlled trial comparing 1- versus 7-day manipulation following collagenase injection for dupuytren contracture.

    PubMed

    Mickelson, Dayne T; Noland, Shelley S; Watt, Andrew J; Kollitz, Kathleen M; Vedder, Nicholas B; Huang, Jerry I

    2014-10-01

    To compare the efficacy, tolerance, and safety of manual manipulation at day 7 to day 1 following collagenase Clostridium histolyticum (CCH) injection for Dupuytren contracture. Eligible patients were randomized to manipulation at day 1 versus day 7 following CCH injection. Preinjection, premanipulation, postmanipulation, and 30-day follow-up metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joint contractures were measured. Pain scores were recorded at each time point. Data were stratified per cohort based on primary joint treated (MCP vs PIP). Means were compared using paired and unpaired t-tests. Forty-three patients with 46 digits were eligible and were randomized to 1-day (22 digits) and 7-day (24 digits) manipulation. For MCP joints, there were no significant differences in flexion contractures between 1- and 7-day cohorts for initial (47° vs 46°), postmanipulation (0° vs 2°), or 30-day follow-up (1° vs 2°) measurements. Premanipulation, the residual contracture was significantly lower in the 7-day group (23° vs 40°). For PIP joints, there were no significant differences between 1- and 7-day cohorts for initial (63° vs 62°), premanipulation (56° vs 52°), postmanipulation (13° vs 15°), or 30-day (14° vs 16°) measurements. There were no significant differences in pain or skin tears between the 2 groups. No flexor tendon ruptures were observed. The effectiveness of CCH in achieving correction of Dupuytren contractures was preserved when manipulation was performed on day 7, with no differences in correction, pain, or skin tears. These data suggest that manipulation can be scheduled at the convenience of the patient and surgeon within the first 7 days after injection. Therapeutic I. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Liquid ventilation

    PubMed Central

    Sarkar, Suman; Paswan, Anil; Prakas, S.

    2014-01-01

    Human have lungs to breathe air and they have no gills to breath liquids like fish. When the surface tension at the air-liquid interface of the lung increases as in acute lung injury, scientists started to think about filling the lung with fluid instead of air to reduce the surface tension and facilitate ventilation. Liquid ventilation (LV) is a technique of mechanical ventilation in which the lungs are insufflated with an oxygenated perfluorochemical liquid rather than an oxygen-containing gas mixture. The use of perfluorochemicals, rather than nitrogen as the inert carrier of oxygen and carbon dioxide offers a number of advantages for the treatment of acute lung injury. In addition, there are non-respiratory applications with expanding potential including pulmonary drug delivery and radiographic imaging. It is well-known that respiratory diseases are one of the most common causes of morbidity and mortality in intensive care unit. During the past few years several new modalities of treatment have been introduced. One of them and probably the most fascinating, is of LV. Partial LV, on which much of the existing research has concentrated, requires partial filling of lungs with perfluorocarbons (PFC's) and ventilation with gas tidal volumes using conventional mechanical ventilators. Various physico-chemical properties of PFC's make them the ideal media. It results in a dramatic improvement in lung compliance and oxygenation and decline in mean airway pressure and oxygen requirements. No long-term side-effect reported. PMID:25886321

  2. Late (>7 days) postnatal corticosteroids for chronic lung disease in preterm infants.

    PubMed

    Halliday, Henry L; Ehrenkranz, Richard A; Doyle, Lex W

    2009-01-21

    Many preterm infants who survive go on to develop chronic lung disease (CLD). This is true in infants who have had respiratory distress syndrome (RDS) and in infants without RDS. This is probably due to persistence of inflammation in the lung. Corticosteroids have powerful anti-inflammatory effects and have been used to treat established CLD. However, it is unclear whether any beneficial effects outweigh the adverse effects of these drugs. To determine the effect of late (> 7 days) postnatal corticosteroid treatment compared to control (placebo or nothing) in the preterm infant with CLD. Randomised controlled trials of postnatal corticosteroid therapy were sought from the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE 1966 through May 2008, hand searching paediatric and perinatal journals, examining previous review articles and information received from practising neonatologists. When possible, authors of all studies were contacted to confirm details of reported follow-up studies or to obtain any information about long-term follow-up where none had been reported. Randomised controlled trials (RCTs) of postnatal corticosteroid treatment initiated after seven days after birth in preterm infants with or developing CLD were selected for this review. Data regarding clinical outcomes including mortality, CLD (including need for home oxygen, or need for late rescue with corticosteroids), death or CLD, failure to extubate, complications in the primary hospitalisation (including infection, hyperglycaemia, glycosuria, hypertension, echodensities on ultrasound scan of brain, necrotising enterocolitis (NEC), gastrointestinal (GI) bleeding, GI perforation, intraventricular hemorrhage (IVH), severe retinopathy of prematurity (ROP), and long-term outcomes (including blindness, deafness, cerebral palsy and major neurosensory disability), were abstracted and analysed using RevMan 5 Nineteen RCTs enrolling a total of 1345 participants were eligible

  3. [Mechanical ventilator].

    PubMed

    Kimura, Akio; Hashimoto, S

    2009-07-01

    The development of the computer technology brought reform in the field of medical equipment. Originally the mechanical ventilator was an instrument only as for running by pressure and the tool that let you breathe. However, it has a function to assist a measurement (tidal volume, peek pressure, etc.) and to wean from a ventilator. There is a case to use a mechanical ventilator for after a chest surgical operation. After the operation without the complication, it seems that there is not the special administration. However, special respiratory management is necessary in case of chronic respiratory failure and acute lung injury, acute respiratory distress syndrome. Therefore I introduce a method to use a respirator after an operation in our institution.

  4. Nasal ventilation.

    PubMed Central

    Simonds, A. K.

    1998-01-01

    Nasal intermittent positive pressure ventilation is likely to have an increasing role in the management of acute ventilatory failure, weaning, and chronic ventilatory problems. Further improvements in ventilator and mask design will be seen. Appropriate application is likely to reduce both mortality and admissions to intensive care, while domiciliary use can improve life expectancy and/or quality of life in chronic ventilatory disorders. As with any new technique, enthusiasm should not outweigh clear outcome information, and possible new indications should always be subject to careful assessment. Images Figure 2 PMID:9799887

  5. Analyzing Drought From Paleo-Reconstructions Of 7-Day Low Flow In The Hudson River Basin

    NASA Astrophysics Data System (ADS)

    Zamora, M. R.; Cook, E.; Gelman, A.; Lall, U.

    2002-12-01

    The annual 7-day low flow in a stream is a measure of the dry season conditions in a stream. Consequently, it is a useful indicator for multi-year droughts. Here, we first present the application of a Generalized Linear Model in a Bayesian Hierarchical Modeling Framework for reconstructing the annual 7-day low flow series at 5 locations in the Hudson River Basin using 11 regional tree ring chronologies. This technique directly provides estimates of the posterior probability distribution of each reconstructed streamflow value, considering model parameter uncertainty. Given these reconstructions, we examine the frequency and recurrence attributes of extreme droughts in the region and their potential connections to known low frequency climate modes.

  6. Improving 7-Day Forecast Skill by Assimilation of Retrieved AIRS Temperature Profiles

    NASA Technical Reports Server (NTRS)

    Susskind, Joel; Rosenberg, Bob

    2016-01-01

    We conducted a new set of Data Assimilation Experiments covering the period January 1 to February 29, 2016 using the GEOS-5 DAS. Our experiments assimilate all data used operationally by GMAO (Control) with some modifications. Significant improvement in Global and Southern Hemisphere Extra-tropical 7-day forecast skill was obtained when: We assimilated AIRS Quality Controlled temperature profiles in place of observed AIRS radiances, and also did not assimilate CrISATMS radiances, nor did we assimilate radiosonde temperature profiles or aircraft temperatures. This new methodology did not improve or degrade 7-day Northern Hemispheric Extra-tropical forecast skill. We are conducting experiments aimed at further improving of Northern Hemisphere Extra-tropical forecast skill.

  7. Portable power supply for continuous mechanical ventilation during intrahospital transport of critically ill patients with ARDS.

    PubMed

    Barton, A C; Tuttle-Newhall, J E; Szalados, J E

    1997-08-01

    Patients with respiratory failure and poor pulmonary compliance requiring high levels of positive pressure ventilation are at high risk during intrahospital transportation. Most ICU ventilators currently do not have a built-in power supply. Manual bag-valve ventilation frequently is used but often without optimum mean airway pressures or minute ventilation guarantees. Transport ventilators also are limited in their ability to provide high positive end-expiratory pressure, variable inspiratory-expiratory ratios, or pressure-controlled ventilation. The 3M SARNS HELP (Hospital Emergency Limited Power) 115, a portable battery, provides continuous power to ICU ventilators and eliminates ventilator circuit interruption for the critical period of patient transportation.

  8. 7-Day Biodefense: Engineered Nanoparticle for Virus Elimination by Opsonization (ENVELOP)

    DTIC Science & Technology

    2013-12-10

    cells using MALDI-MS and MS/MS (TOF-TOF) analyses for carbohydrate characterization and NMR for linkage information. To elaborate the diversity of the... training of Draper staff on development and execution of SOPs. A GLP-compatible protocol for production of glycan- bearing liposomes was also developed...Aug-2010 30-Sep-2013 Approved for Public Release; Distribution Unlimited 7-Day Biodefense: Engineered Nanoparticle for Virus Elimination by

  9. [Modalities of mechanical ventilation].

    PubMed

    Subirana, M; Bazan, P

    2000-01-01

    Mechanical ventilation improves the symptoms and reduces complications of acute respiratory failure. Recent advances in microprocessor technology have increased the sophistication of mechanical ventilators, thus leading to new ventilation modalities. This article describes the ventilation modalities available, grouping them as conventional, alternative and new modalities. Conventional ventilation includes the most widely used modalities, alternative ventilation includes less frequently used modalities, and new ventilation modalities include recently introduced options that are available on the latest-generation mechanical ventilators.

  10. Rainbow trout (Oncorhynchus mykiss) and brook trout (Salvelinus fontinalis) 7-day survival and growth test method.

    PubMed

    Lazorchak, James M; Smith, Mark E

    2007-10-01

    A short-term method was developed in this study for conducting subchronic survival and growth renewal toxicity tests with rainbow trout (Oncorhynchus mykiss) and brook trout (Salvelinus fontinalis). Previously published early life-stage methods for various salmonid species involve test durations of 30 to 90 days. This trout method, however, follows a previously published 7-day fathead minnow (Pimephales promelas) growth method. The tests performed in this study measured subchronic growth and survival effects using standard reference toxicants (ammonium chloride, potassium chloride, phenol, and zinc sulfate), receiving water, and effluent samples. The test results were compared with performance criteria and results for 7-day survival and growth tests with P. promelas to determine the level of comparability between the two species. The results from tests with both salmonid species indicated that this 7-day survival and growth test method using O. mykiss and S. fontinalis provides reproducible results with various reference toxicant materials and can be used successfully to detect potential toxicity in environmental samples.

  11. Efficacy of Conventional and High-Frequency Ventilation at Altitude

    DTIC Science & Technology

    1988-12-01

    Lung volume was estimated by nitrogen dilution using a closed circuit rebreathing technique. 31 The same data collection protocol was employed for both...Fig. No. 1. Experimental preparation ......... .................... 6 2. Ventilator circuit used for washin during CMV .... .......... 9 3. Oscillator... circuit used for washin during HFV ............ . .11 4. Valve assembly used in measurements of inert gases ........ 17 5. Gas concentrations in

  12. Microbiological safety and cost-effectiveness of weekly breathing circuit changes in combination with heat moisture exchange filters: a prospective longitudinal clinical survey

    PubMed Central

    Hübner, Nils-Olaf; Daeschlein, Georg; Lehmann, Christian; Musatkin, Sergei; Kohlheim, Ute; Gibb, Andreas; Assadian, Ojan; Kobayashi, Hiroyoshi

    2011-01-01

    Aim: To assess the safety and cost effectiveness of a usage for seven days of breathing circuit systems (BCSs) in combination with heat moisture exchanger filters (HMEF) in operation room anesthesia. Method: In a prospective longitudinal clinical study, the contamination on high-risk surfaces (HMEF together with inner and outer surface of BCS) was monitored over 1, 2, 5, and 7 days. Results of endogenous respiratory patient flora and contamination flora of BCS, HMEF and bag were compared. Costs of prolonged use of BCS together with HMEF up to 7 days were calculated. Results: Neither physiological respiratory flora nor colonizing pathogens of the oropharynx of the ventilated patients were transmitted through the filters at any time. None of the included patients developed a postoperative pneumonia. Using the BCS for 24 hours provides a cost savings of up to 40% versus single use. Extending the change interval from 24 hours to 48 hours saved over 50% compared to change after each patient, and an additional 19% compared to change after 24 hours. In combination with a HMEF BCS can be used up to 7 days without clinical risk on multiple patients in operation room settings. Conclusion: Expanding the usage of berating in combination with usage of moist exchange filters is feasible, microbiologically safe and cost effective, as 41% of material costs per ventilation may be saved. Further research is needed to confirm these results. PMID:22242096

  13. High intake of milk, but not meat, decreases bone turnover in prepubertal boys after 7 days.

    PubMed

    Budek, A Z; Hoppe, C; Michaelsen, K F; Mølgaard, C

    2007-08-01

    To compare the short-term effect of a high milk and a high meat intake, identical in protein amount, on bone turnover during prepuberty. A University department. From 28, randomly recruited, 8-year-old boys, first 14 were assigned to the milk group and next 14 to the meat group. In each group, 12 boys finished the dietary intervention. Milk (1.5 l/day) and meat (250 g/d), both containing approximately 53 g of protein, were given together with the habitual diet for 7 days. At baseline and day-7, serum osteocalcin (s-OC), bone-specific alkaline phosphatase (s-BAP) and C-terminal telopeptides of type I collagen (s-CTX) were measured (immunoassay) and dietary intake was estimated (a 3-day weighted food record). Baseline s-OC, s-BAP and s-CTX were not significantly different between the groups. After 7 days, the average protein intake increased in both groups by 47.5 g; the milk group had higher (P<0.0001) calcium intake; s-OC and s-CTX decreased (P< or =0.04) in the milk group (-30.9%; -18.7%, respectively) compared with the meat group (+6.4%; -1.0%, respectively) and s-BAP decreased (P=0.06) both in the milk (-3.9%) and the meat group (-7.5%). At the equal protein intake, milk, but not meat, decreased bone turnover in prepubertal boys after 7 days. This effect was probably due to some milk-derived compounds, rather than to the total protein intake. Future studies should elucidate the mechanism(s) of milk-related decline of bone turnover and its relevance for peak bone mass during growth. University PhD scholarships.

  14. Eccentric and concentric muscle performance following 7 days of simulated weightlessness

    NASA Technical Reports Server (NTRS)

    Hayes, Judith C.; Roper, Mary L.; Mazzocca, Augustus D.; Mcbrine, John J.; Barrows, Linda H.; Harris, Bernard A.; Siconolfi, Steven F.

    1992-01-01

    Changes in skeletal muscle strength occur in response to chronic disuse or insufficient functional loading. The purpose of this study was to examine changes in muscle performance of the lower extremity and torso prior to and immediately after 7 days of simulated weightlessness (horizontal bed rest). A Biodex was used to determine concentric and eccentric peak torque and angle at peak torque for the back, abdomen, quadriceps, hamstring, soleus, and tibialis anterior. A reference angle of 0 degrees was set at full extension. Data were analyzed by ANOVA.

  15. Mine ventilation and air conditioning. 3. edition

    SciTech Connect

    Hartman, H.L.; Mutmansky, J.M.; Ramani, R.V.; Wang, Y.J.

    1998-12-31

    This revised edition presents an engineering design approach to ventilation and air conditioning as part of the comprehensive environmental control of the mine atmosphere. It provides an in-depth look, for practitioners who design and operate mines, into the health and safety aspects of environmental conditions in the underground workplace. The contents include: Environmental control of the mine atmosphere; Properties and behavior of air; Mine air-quality control; Mine gases; Dusts and other mine aerosols; Mine ventilation; Airflow through mine openings and ducts; Mine ventilation circuits and networks; Natural ventilation; Fan application to mines; Auxiliary ventilation and controlled recirculation; Economics of airflow; Control of mine fires and explosions; Mine air conditioning; Heat sources and effect in mines; Mine air conditioning systems; Appendices; References; Answers to selected problems; and Index.

  16. A model humanitarian cleft mission: 312 cleft surgeries in 7 days.

    PubMed

    Fayyaz, Ghulam Qadir; Gill, Nauman Ahmad; Ishaq, Irfan; Ganatra, Muhammad Ashraf; Mahmood, Farrakh; Kashif, Muhammad; Alam, Iftikhar; Chen, Philip Kuo-Ting; Lo, Lun-Jou; Laub, Donald Rudolph

    2015-03-01

    There are many countries in the world where patients with cleft lip and palate cannot get access to specialized cleft care units. Cleft missions play an important role in providing surgical care to the areas of the world with limited resources. This article presents a model of cleft missions that can be adopted in many countries where expertise is available but resources are limited. Through proper utilization of local human resource, this type of mission can be a cost-effective and robust way of treating patients with cleft in countries with approximately 52% of the world's population. We present a case series of patients of one of our cleft missions carried out in Khairpur, Pakistan, in March 2014 over a period of 7 days. Specific details concerning the organization of mission, gathering of patients, preparation for surgery, and carrying out surgical procedures in a safe and swift manner are presented. A total of 312 patients were operated on in 7 days. There were 145 patients with cleft lip and 167 patients with cleft palate. There were 187 male and 125 female patients with mean age of 7 years. Contemporary operative techniques were utilized to repair different types of cleft lip and palate. Of 167 patients, only 16 developed fistula. A locoregional cleft team can be more effective to care for the patients with cleft in countries where surgical and other expertise can be utilized by proper organization of cleft missions on a national level.

  17. Outcomes of reduction more than 7 days after injury in supracondylar humeral fractures in children.

    PubMed

    Silva, Mauricio; Wong, Thalia C; Bernthal, Nicholas M

    2011-01-01

    Some slightly extended type II fractures initially treated with closed reduction and casting can displace during the first 2 weeks of follow-up. Although closed reduction and percutaneous pinning are desirable for displaced supracondylar humeral fractures treated acutely, there is little or no available information regarding the surgeon's ability to obtain a satisfactory reduction when such a procedure is performed more than a week after the original injury, or the clinical outcome of it. We reviewed the information on 143 type II pediatric supracondylar humeral fractures that were treated by closed reduction and percutaneous pinning. To determine the effect of late treatment, we compared a group of fractures that was treated within the first 7 days (group 1, n=101) with a group that was treated >7 days after the injury (group 2, n=42). Mean time from presentation to surgery was 2.1 days (range, 0 to 5) and 9.8 days (range, 7 to 15) for fractures in groups 1 and 2, respectively. There was no need for an open reduction in either group. An anatomic reduction was obtained in all fractures. There were no iatrogenic nerve injuries, vascular complications, or compartment syndromes in either group. Length of surgery was similar in both groups (P=0.3). There were no significant differences in final carrying angle (P=0.2) or range of motion of the treated elbow (P=0.21). Avascular necrosis of the humeral trochlea was identified in 2 fractures that were treated surgically 8 days after the original injury (group 2). The results of this study suggest that it is possible to obtain an anatomic reduction of a type II pediatric supracondylar humeral fracture even after 7 days from the injury. Such a delay in surgery does not appear to lead to longer surgeries, a higher incidence of open reduction, or to alter the final alignment or range of motion of the elbow. However, the risk of developing an avascular necrosis of the humeral trochlea must be considered. II.

  18. Metabolic and psychological response to 7-day fasting in obese patients with and without metabolic syndrome.

    PubMed

    Li, Chenying; Ostermann, Thomas; Hardt, Monika; Lüdtke, Rainer; Broecker-Preuss, Martina; Dobos, Gustav; Michalsen, Andreas

    2013-01-01

    Extended modified fasting is a frequently practiced tradition in Europe. It is claimed to improve the cardiometabolic state and physical and psychological well-being by an evolutionary co-developed adaptation response. We aimed to investigate the cardiometabolic and psychological effects of a 7-day fast and differences of these responses between patients with or without metabolic syndrome (MetS). We investigated 30 female subjects (49.0 ± 8.1 years, BMI 30.4 ± 6.7 kg/m(2)) with (n = 12) and without (n = 18) MetS. All subjects participated in a 7-day fast according to Buchinger with a nutritional energy intake of 300 kcal/day and stepwise reintroduction of solid food thereafter. Outcomes were assessed baseline and after fasting and included measures of metabolic and glucoregulatory control, adipokines as well as psychological well-being as assessed by Profile of Mood States (POMS) and Hospital Anxiety and Depression Scale (HADS). Mean weight decreased from 85.4 ± 18.8 kg to 79.7 ± 18.2 kg accompanied by systolic/diastolic blood pressure (BP) reduction of -16.2 mm Hg (95% CI: -9.1; -23.3 mm Hg) and -6.0 mm Hg (95% CI: -1.8; -10.3 mm Hg), each p < 0.001 and p = 0.005. Fasting led to marked decreases of levels of LDL-cholesterol, leptin, and insulin and increases of levels of adiponectin, leptin receptors, and resistin. Fasting-induced mood enhancement was reflected by decreased anxiety, depression, fatigue, and improved vigor. Patients with MetS showed some greater changes in B P, LDL-cholesterol, triglycerides, adiponectin, leptin, and sleep quality. Fasting was well-tolerated. Our results point to marked beneficial responses to 7-day modified fasting and a potential role in the prevention of the MetS. Randomized trials with longer observation periods should test the clinical effectiveness of fasting in metabolic diseases. © 2014 S. Karger GmbH, Freiburg.

  19. Congenital Diaphragmatic Hernia Presenting in a 7-Day-Old Infant.

    PubMed

    Rouse, Christopher; Schmidt, Luke; Brock, Lee; Fagiana, Angela

    2017-01-01

    A 7-day-old male infant presented to the emergency room after respiratory distress was noted at an outpatient well child check. On exam, he was observed to have tachypnea, increased work of breathing, and decreased breath sounds on the left side of the chest. On chest X-ray, he was found to have a left-sided congenital diaphragmatic hernia. The infant was transported to a tertiary care facility where the defect was repaired without complication. Interestingly, the mother had a history of a normal antenatal ultrasound, completed at 19 + 2 weeks of gestational age. This case report summarizes the challenges of diagnosing late-presenting congenital diaphragmatic hernia, associated malformations, possible etiologies, and prognosis.

  20. Congenital Diaphragmatic Hernia Presenting in a 7-Day-Old Infant

    PubMed Central

    Schmidt, Luke; Brock, Lee; Fagiana, Angela

    2017-01-01

    A 7-day-old male infant presented to the emergency room after respiratory distress was noted at an outpatient well child check. On exam, he was observed to have tachypnea, increased work of breathing, and decreased breath sounds on the left side of the chest. On chest X-ray, he was found to have a left-sided congenital diaphragmatic hernia. The infant was transported to a tertiary care facility where the defect was repaired without complication. Interestingly, the mother had a history of a normal antenatal ultrasound, completed at 19 + 2 weeks of gestational age. This case report summarizes the challenges of diagnosing late-presenting congenital diaphragmatic hernia, associated malformations, possible etiologies, and prognosis. PMID:28133553

  1. Constructing a 7-day ahead forecast model for grass pollen at north London, United Kingdom.

    PubMed

    Smith, M; Emberlin, J

    2005-10-01

    A number of media outlets now issue medium-range ( approximately 7 day) weather forecasts on a regular basis. It is therefore logical that aerobiologists should attempt to produce medium-range forecasts for allergenic pollen that cover the same time period as the weather forecasts. The objective of this study is to construct a medium-range (7 day) forecast model for grass pollen at north London. The forecast models were produced using regression analysis based on grass pollen and meteorological data from 1990 to 1999 and tested on data from 2000 and 2002. The modelling process was improved by dividing the grass pollen season into three periods; the pre-peak, peak and post-peak periods of grass pollen release. The forecast consisted of five regression models: two simple linear regression models predicting the start and end date of the peak period, and three multiple regression models forecasting daily average grass pollen counts in the pre-peak, peak and post-peak periods. Overall, the forecast models achieved 62% accuracy in 2000 and 47% in 2002, reflecting the fact that the 2002 grass pollen season was of a higher magnitude than any of the other seasons included in the analysis. This study has the potential to make a notable contribution to the field of aerobiology. Winter averages of the North Atlantic Oscillation were used to predict certain characteristics of the grass pollen season, which presents an important advance in aerobiological work. The ability to predict allergenic pollen counts for a period between five and seven days will benefit allergy sufferers. Furthermore, medium-range forecasts for allergenic pollen will be of assistance to the medical profession, including allergists planning treatment and physicians scheduling clinical trials.

  2. Acute medicine targets: when should the clock start and 7-day consultant impact?

    PubMed

    Lang, S; Cooksley, T; Foden, P; Holland, M

    2015-08-01

    Early consultant review has been shown to improve outcomes in patients presenting to the Acute Medical Unit (AMU). The Society for Acute Medicine (SAM) clinical quality indicators use the time of arrival on the AMU for target rather than arrival in the Emergency Department (ED) although this is where most acute medical patients present. To determine the effect of a 7-day Consultant Acute Physician model on patient waiting times and assess the impact of starting the clock for medical patients at time of ED arrival. We performed an audit at a University Hospital AMU in the North West of England. Data were collected prospectively for 15 consecutive days in May-June 2013 for all patients presenting to the AMU at University Hospital of South Manchester and were repeated for the same time period in 2014 following the introduction of a new Consultant working model. Four hundred and five patients were admitted to the AMU in the 2013 cohort compared to 456 in the 2014 cohort. There was a significant improvement in the median waiting time for Consultant review from AMU admission to 5 h 53 min from 8 h 15 min (P < 0.001). The compliance with the SAM quality indicator for Consultant review improved from 88.7 to 93.7% (P = 0.022). A 7-day Acute Physician working model is improving performance with regards to patient waiting times. We suggest that starting the clock for acute medical patients in the ED is a better measure of performance than on arrival to the AMU. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Changes of human serum proteome profile during 7-day “dry” immersion

    NASA Astrophysics Data System (ADS)

    Pakharukova, N. A.; Pastushkova, L. Kh.; Larina, I. M.; Grigoriev, A. I.

    2011-05-01

    The aim of this study was to characterize changes of serum proteome profile during 7-day "dry" immersion (DI). The experiment with DI consisted of three series: control group without countermeasures (10 men), with using mechanical stimulation (6 men) and low-frequency myostimulation (5 men) as preventive means. Serum samples were fractionated using ClinProt robot (Bruker Daltonics) on magnetic beads (weak cation exchange magnetic beads—MB WCX) prior to mass-spectral profiling. It was obtained 170 peaks after fractionation of serum samples in each group. On 7th immersion day peak areas of fibrinopeptide A ( m/ z=1206; 1464), angiotensin II ( m/ z=1051), high molecular mass kininogen fragment ( m/ z=2133 Da) and C3-fragment of the complement system ( m/ z=1350 Da) were significantly decreased comparing with pre-experimental values of all experimental series. Peak areas of apolipoprotein C III ( m/ z=9419) and C4a fragment of the complement system ( m/ z=3206 Da) were increased. On 7th day of the recovery peak areas of all changed peaks were not close to pre-experimental values. This fact provided evidence of incomplete recovery of an organism after DI. The depth of the alterations had considerable individual variability. Thereby the detected changes of serum proteome profile in the experiment. They indicated a reorganization of the hormonal, immune systems and lipid metabolism. The use of myostimulation and mechanical stimulation as countermeasures partly compensated adverse effects of 7-day dry immersion on the parameters of coagulation system (fibrinopeptide A) and lipid metabolism (apolipoprotein CIII).

  4. Measuring circuit

    DOEpatents

    Sun, Shan C.; Chaprnka, Anthony G.

    1977-01-11

    An automatic gain control circuit functions to adjust the magnitude of an input signal supplied to a measuring circuit to a level within the dynamic range of the measuring circuit while a log-ratio circuit adjusts the magnitude of the output signal from the measuring circuit to the level of the input signal and optimizes the signal-to-noise ratio performance of the measuring circuit.

  5. Psychometric properties of the 7-Day Physical Activity Recall questionnaire in individuals with severe mental illness.

    PubMed

    Soundy, Andy; Taylor, Adrian; Faulkner, Guy; Rowlands, Ann

    2007-12-01

    Few self-report measures of physical activity have been validated in individuals with severe mental illness. The purpose of this study was to examine the validity and reliability of a 7-day recall measure (7DR: [Blair, S. N. (1984). How to assess exercise habits and physical fitness. In J. D. Matarazzo, N. E. Miller, & S. M. Weiss, (Eds.), Behavioural health: A handbook of health enhancement and disease prevention (pp. 424-447). New York: Wiley.]) through comparison with RT3 triaxial accelerometry data. Fourteen individuals took part in the study. Validity was considered by Kendall's tau correlation and (Bland, J. M., & Altman, D. G. (1986). Statistical-methods for assessing agreement between 2 methods of clinical measurement. Lancet, 1(8476), 307-310) limits of agreement and test-retest reliability was measured by ICC. The only significant correlation between measures was total energy expenditure (tau = 0.43). The 7-DR over reported moderate physical activity by 16.9 +/- 52.3 min/day, but under reported vigorous physical activity by -10.4 +/- 24.3 min/day. Test retest ICC was significant for all outcome measures. Overall, the 7-DR was reliable but exhibited questionable validity. The use of self-report questionnaires such as the 7-DR may inaccurately estimate the levels of physical activity in this population, and may not be sensitive to monitoring intervention-related changes in physical activity.

  6. Autonomous Motivation Predicts 7-Day Physical Activity in Hong Kong Students.

    PubMed

    Ha, Amy S; Ng, Johan Y Y

    2015-07-01

    Autonomous motivation predicts positive health behaviors such as physical activity. However, few studies have examined the relation between motivational regulations and objectively measured physical activity and sedentary behaviors. Thus, we investigated whether different motivational regulations (autonomous motivation, controlled motivation, and amotivation) predicted 7-day physical activity, sedentary behaviors, and health-related quality of life (HRQoL) of students. A total of 115 students (mean age = 11.6 years, 55.7% female) self-reported their motivational regulations and health-related quality of life. Physical activity and sedentary behaviors were measured using accelerometers for seven days. Using multilevel modeling, we found that autonomous motivation predicted higher levels of moderate-to-vigorous physical activity, less sedentary behaviors, and better HRQoL. Controlled motivation and amotivation each only negatively predicted one facet of HRQoL. Results suggested that autonomous motivation could be an important predictor of physical activity behaviors in Hong Kong students. Promotion of this form of motivational regulation may also increase HRQoL.

  7. Predictive Factors for Delivery within 7 Days after Successful 48-Hour Treatment of Threatened Preterm Labor.

    PubMed

    Roos, Carolien; Schuit, Ewoud; Scheepers, Hubertina C J; Bloemenkamp, Kitty W M; Bolte, Antoinette C; Duvekot, Hans J J; van Eyck, Jim; Kok, Joke H; Kwee, Anneke; Merién, Ashley E R; Opmeer, Brent C; Oudijk, Martijn A; van Pampus, Mariëlle G; Papatsonis, Dimitri N M; Porath, Martina M; Sollie, Krystyna M; Spaanderman, Marc E A; Vijgen, Sylvia M C; Willekes, Christine; Lotgering, Fred K; van der Post, Joris A M; Mol, Ben Willem J

    2015-10-01

    Objective The aim of this study was to assess which characteristics and results of vaginal examination are predictive for delivery within 7 days, in women with threatened preterm labor after initial treatment. Study Design A secondary analysis of a randomized controlled trial on maintenance nifedipine includes women who remained undelivered after threatened preterm labor for 48 hours. We developed one model for women with premature prelabor rupture of membranes (PPROM) and one without PPROM. The predictors were identified by backward selection. We assessed calibration and discrimination and used bootstrapping techniques to correct for potential overfitting. Results For women with PPROM (model 1), nulliparity, history of preterm birth, and vaginal bleeding were included in the multivariable analysis. For women without PPROM (model 2), maternal age, vaginal bleeding, cervical length, and fetal fibronectin (fFN) status were in the multivariable analysis. Discriminative capability was moderate to good (c-statistic 0.68; 95% confidence interval [CI] 0.60-0.77 for model 1 and 0.89; 95% CI, 0.84-0.93 for model 2). Conclusion PPROM and vaginal bleeding in the current pregnancy are relevant predictive factors in all women, as are maternal age, cervical length, and fFN in women without PPROM and nulliparity, history of preterm birth in women with PPROM.

  8. A 7-day intravenous toxicity study and neurotoxicity assessment of pyridorin in Sprague-Dawley rats.

    PubMed

    Sullivan, D W; Peterson, R C; Mujer, C V; Gad, S C

    2017-07-01

    Pyridorin(®), a naturally occurring metabolite of vitamin B6 that inhibits and scavenges reactive oxygen species, is being developed as a potential therapeutic for acute kidney injury. An investigational new drug application (IND) was opened for Pyridorin in support of its ongoing oral drug clinical development program. Currently, a Pyridorin intravenous (IV) formulation is being developed for use in surgical patients. To support the IND for Pyridorin, a full battery of nonclinical Good Laboratory Practice compliant studies was performed with no neurological or behavioral signs of toxicity seen following oral or IV administration of pyridoxine dihydrochloride (the active ingredient in Pyridorin). However, excessive ingestion of vitamin B6 has been reported to cause neurotoxic syndrome in humans. Therefore, under Food and Drug Administration recommendation, a 7-day IV study in rats was conducted to further evaluate the drug's potential to cause neurotoxicity. Blood plasma samples indicated that exposure to pyridoxamine dihydrochloride and its metabolites, pyridoxal, pyridoxine, and 4-pyridoxic acid was linearly dose proportional and independent of gender. At doses of up to 200 mg/kg/day pyridoxine dihydrochloride, no treatment-related effects were seen in rats, providing further evidence for the absence of pyridoxine dihydrochloride-related changes in the nervous system. A no observed adverse effect level of 200 mg/kg/day was identified for this study.

  9. Predictive Factors for Delivery within 7 Days after Successful 48-Hour Treatment of Threatened Preterm Labor

    PubMed Central

    Roos, Carolien; Schuit, Ewoud; Scheepers, Hubertina C. J.; Bloemenkamp, Kitty W. M.; Bolte, Antoinette C.; Duvekot, Hans J. J.; van Eyck, Jim; Kok, Joke H.; Kwee, Anneke; Merién, Ashley E. R.; Opmeer, Brent C.; Oudijk, Martijn A.; van Pampus, Mariëlle G.; Papatsonis, Dimitri N. M.; Porath, Martina M.; Sollie, Krystyna M.; Spaanderman, Marc E. A.; Vijgen, Sylvia M. C.; Willekes, Christine; Lotgering, Fred K.; van der Post, Joris A. M.; Mol, Ben Willem J.

    2015-01-01

    Objective The aim of this study was to assess which characteristics and results of vaginal examination are predictive for delivery within 7 days, in women with threatened preterm labor after initial treatment. Study Design A secondary analysis of a randomized controlled trial on maintenance nifedipine includes women who remained undelivered after threatened preterm labor for 48 hours. We developed one model for women with premature prelabor rupture of membranes (PPROM) and one without PPROM. The predictors were identified by backward selection. We assessed calibration and discrimination and used bootstrapping techniques to correct for potential overfitting. Results For women with PPROM (model 1), nulliparity, history of preterm birth, and vaginal bleeding were included in the multivariable analysis. For women without PPROM (model 2), maternal age, vaginal bleeding, cervical length, and fetal fibronectin (fFN) status were in the multivariable analysis. Discriminative capability was moderate to good (c-statistic 0.68; 95% confidence interval [CI] 0.60–0.77 for model 1 and 0.89; 95% CI, 0.84–0.93 for model 2). Conclusion PPROM and vaginal bleeding in the current pregnancy are relevant predictive factors in all women, as are maternal age, cervical length, and fFN in women without PPROM and nulliparity, history of preterm birth in women with PPROM. PMID:26495173

  10. Light smoking in a predominantly Hispanic college student sample: a 7 day diary assessment.

    PubMed

    Taylor, Thom; Cooper, Theodore V

    2010-12-01

    Both Hispanic and college student populations smoke at non trivial rates but less frequently than other smoking groups. Limited information exists about the at risk times for smoking among those who smoke fewer than 10 cigarettes per day, particularly college students. Participants (n=116 young adults) completed a 7 day Tobacco Consumption Diary by recording for each cigarette smoked: time and day, location, number of people present, number of smokers present, mood, and whether alcohol was consumed. Descriptive analyses suggest a variety of psycho-social contexts within which light smoking may occur for a predominantly Hispanic sample of college students. Inferential analyses reveal a somewhat heterogeneous pattern of light smoking. Nevertheless, Thursday, Friday, and Saturday, as well as later hours of each day in particular are associated with an increased likelihood of smoking. Further study of intra-individual patterns of both Hispanic and college student light smoking is needed to identify the ideographic triggers that can be intervened upon to aid light smokers in cessation. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. [Hemostasis system indices after short-term space flights and during 7-day "dry" immersion experiment].

    PubMed

    Kuzichkin, D S; Morukov, B V; Markin, A A; Zhuravleva, O A; Zabolotskaia, I V; Vostrikova, L V

    2010-01-01

    The present paper deals with studying ofhemostasis system indices after short-term (10-11 days) space flights as well as in the course of the experiment with a 7-day "dry" immersion. The following values were determined: activated partial thromboplastin time, prothrombin time, prothrombin index, international normalized ratio (INR), thrombin time (TT); fibrinogen, soluble fibrin-monomer complexes, D-dimer, plasminogen (PG) concentration; activity of antithrombin III (ATIII), protein C (PC), alpha2-antiplasmin (AP). In the 1st day after space flights a fibrinogen concentration was increased significantly as well as TT shortening tendency and fibrinolysis activation tendency were observed. There were no significant changes in ATI I11 and PC activities. During the immersion period there were no significant changes in investigated indices, with the exception of AP activity increase in 3rd day of experiment. In readaptation period, however, a decrease in ATIII and PC activities as well as PG concentration was observed. Hemostasis system response features after space flights and during immersion are probably due to different intensity and duration of external factors effects.

  12. Two waves of a long-lasting aftereffect of prism adaptation measured over 7 days.

    PubMed

    Hatada, Y; Miall, R C; Rossetti, Y

    2006-03-01

    Prism adaptation is a useful paradigm to study the integration and reorganization of various sensory modalities involved in sensory-motor tasks. By prolonging the prismatic aftereffect and well-timed observation, we aimed to dissociate the components and mechanisms involved in human prism adaptation by their differential decay and development time courses. Here, we show that a single session of prism adaptation training, combining small increments of prism strength below the subjects' awareness threshold, during a pointing task with a free walk session with total prism exposure duration of 75 min, generated a surprisingly long-lasting aftereffect. The aftereffect was measured by the magnitude of the proprioceptive shift (assessed by straight-ahead pointing in the dark) for 7 days. An aftereffect was observed, which lasted for more than 6 days, by a single prism adaptation session. The aftereffect did not decay gradually. Unlike previous descriptions, the aftereffect showed two separate time-courses of decay and increase. After a significant initial decay within 6 h, the aftereffect increased again from 1 day up to 3 days. The novel decay and delayed development profile of this adaptation aftereffect suggests two separate underlying neural mechanisms with different time scales. Our experimental paradigms promise to reveal directly the temporal characteristics of early versus late long-term neural plasticity in complex human adaptive behavior.

  13. Pyruvate ingestion for 7 days does not improve aerobic performance in well-trained individuals

    NASA Technical Reports Server (NTRS)

    Morrison, M. A.; Spriet, L. L.; Dyck, D. J.

    2000-01-01

    The purposes of the present studies were to test the hypotheses that lower dosages of oral pyruvate ingestion would increase blood pyruvate concentration and that the ingestion of a commonly recommended dosage of pyruvate (7 g) for 7 days would enhance performance during intense aerobic exercise in well-trained individuals. Nine recreationally active subjects (8 women, 1 man) consumed 7, 15, and 25 g of pyruvate and were monitored for a 4-h period to determine whether blood metabolites were altered. Pyruvate consumption failed to significantly elevate blood pyruvate, and it had no effect on indexes of carbohydrate (blood glucose, lactate) or lipid metabolism (blood glycerol, plasma free fatty acids). As a follow-up, we administered 7 g/day of either placebo or pyruvate, for a 1-wk period to seven, well-trained male cyclists (maximal oxygen consumption, 62.3 +/- 3.0 ml. kg(-1). min(-1)) in a randomized, double-blind, crossover trial. Subjects cycled at 74-80% of their maximal oxygen consumption until exhaustion. There was no difference in performance times between the two trials (placebo, 91 +/- 9 min; pyruvate, 88 +/- 8 min). Measured blood parameters (insulin, peptide C, glucose, lactate, glycerol, free fatty acids) were also unaffected. Our results indicate that oral pyruvate supplementation does not increase blood pyruvate content and does not enhance performance during intense exercise in well-trained cyclists.

  14. The development of a 7-day community specialist palliative care service.

    PubMed

    Gallagher, Jennifer

    2013-12-01

    The author worked as a clinical nurse specialist (CNS) in community palliative care in the Central Lancashire area of England when the CNS service was extended to a 9am-to-5pm 7-day service. A project group was set up to canvas some of the key stakeholders for their views on the extension of the service. The group undertook a literature search, a telephone survey of services in other areas that were providing this level of service, and interviews to ascertain the views of district nurses in the locality of the proposed service extension. The extension of service has long been advocated and was one of the key recommendations in the UK Department of Health's peer-review process. Such an extension was implemented following the research phase and was then evaluated by the project lead and the community services manager. The extension was found to be effective in the ongoing monitoring and support of patients. Anecdotally, the CNS team also felt it had been proactive in preventing unnecessary hospital admissions, although this specific aspect is difficult to quantify. This article looks at how the service was developed, how it has evolved over time, and how it works today. Consideration is also given to benefits and limitations.

  15. Pyruvate ingestion for 7 days does not improve aerobic performance in well-trained individuals

    NASA Technical Reports Server (NTRS)

    Morrison, M. A.; Spriet, L. L.; Dyck, D. J.

    2000-01-01

    The purposes of the present studies were to test the hypotheses that lower dosages of oral pyruvate ingestion would increase blood pyruvate concentration and that the ingestion of a commonly recommended dosage of pyruvate (7 g) for 7 days would enhance performance during intense aerobic exercise in well-trained individuals. Nine recreationally active subjects (8 women, 1 man) consumed 7, 15, and 25 g of pyruvate and were monitored for a 4-h period to determine whether blood metabolites were altered. Pyruvate consumption failed to significantly elevate blood pyruvate, and it had no effect on indexes of carbohydrate (blood glucose, lactate) or lipid metabolism (blood glycerol, plasma free fatty acids). As a follow-up, we administered 7 g/day of either placebo or pyruvate, for a 1-wk period to seven, well-trained male cyclists (maximal oxygen consumption, 62.3 +/- 3.0 ml. kg(-1). min(-1)) in a randomized, double-blind, crossover trial. Subjects cycled at 74-80% of their maximal oxygen consumption until exhaustion. There was no difference in performance times between the two trials (placebo, 91 +/- 9 min; pyruvate, 88 +/- 8 min). Measured blood parameters (insulin, peptide C, glucose, lactate, glycerol, free fatty acids) were also unaffected. Our results indicate that oral pyruvate supplementation does not increase blood pyruvate content and does not enhance performance during intense exercise in well-trained cyclists.

  16. Leakage estimation using Kalman filtering in noninvasive mechanical ventilation.

    PubMed

    Rodrigues, G G; Freitas, U S; Bounoiare, D; Aguirre, L A; Letellier, C

    2013-05-01

    Noninvasive mechanical ventilation is today often used to assist patient with chronic respiratory failure. One of the main reasons evoked to explain asynchrony events, discomfort, unwillingness to be treated, etc., is the occurrence of nonintentional leaks in the ventilation circuit, which are difficult to account for because they are not measured. This paper describes a solution to the problem of variable leakage estimation based on a Kalman filter driven by airflow and the pressure signals, both of which are available in the ventilation circuit. The filter was validated by showing that based on the attained leakage estimates, practically all the untriggered cycles can be explained.

  17. VENTILATION NEEDS DURING CONSTRUCTION

    SciTech Connect

    C.R. Gorrell

    1998-07-23

    The purpose of this analysis is to determine ventilation needs during construction and development of the subsurface repository and develop systems to satisfy those needs. For this analysis, construction is defined as pre-emplacement excavation and development is excavation that takes place simultaneously with emplacement. The three options presented in the ''Overall Development and Emplacement Ventilation Systems'' analysis (Reference 5.5) for development ventilation will be applied to construction ventilation in this analysis as well as adding new and updated ventilation factors to each option for both construction and development. The objective of this analysis is to develop a preferred ventilation system to support License Application Design. The scope of this analysis includes: (1) Description of ventilation conditions; (2) Ventilation factors (fire hazards, dust control, construction logistics, and monitoring and control systems); (3) Local ventilation alternatives; (4) Global ventilation options; and (5) Evaluation of options.

  18. Variable mechanical ventilation

    PubMed Central

    Fontela, Paula Caitano; Prestes, Renata Bernardy; Forgiarini Jr., Luiz Alberto; Friedman, Gilberto

    2017-01-01

    Objective To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Methods Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation". Results A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Conclusion Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation. PMID:28444076

  19. Variable mechanical ventilation.

    PubMed

    Fontela, Paula Caitano; Prestes, Renata Bernardy; Forgiarini, Luiz Alberto; Friedman, Gilberto

    2017-01-01

    To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation". A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.

  20. THE RELATIONSHIP BETWEEN CIRCADIAN BLOOD PRESSURE VARIATION AND AGE ANALYSED FROM 7-DAY MONITORING

    PubMed Central

    SIEGELOVÁ, J.; DUŠEK, J.; FIŠER, B.; HOMOLKA, P.; VANK, P.; MAŠEK, M.; HAVELKOVÁ, A.; CORNÉLISSEN, G.; HALBERG, F.

    2009-01-01

    The relationship between age and circadian blood pressure (BP) variation was the aim of the present study. One hundred and eighty-seven subjects (130 males, 57 females), 20-77 years old, were recruited for seven-day BP monitoring. Colin medical instruments (Komaki, Japan) were used for ambulatory BP monitoring (oscillation method, 30-minute interval between measurements). A sinusoidal curve was fitted (minimum square method) and the mean value and amplitude of the curve (double amplitude corresponds to the night-day difference) were evaluated on every day of monitoring. The average 7-day values of the mean (M) and of double amplitude (2A) for systolic BP (SBP), diastolic BP (DBP), and heart rate (HR) were determined in each subject. The mean values of M (±SD) for the whole group were: SBP- 127±8, DBP - 79±6 mmHg, HR - 70±6 bpm; of 2A: SBP - 21±7, DBP - 15±5 mmHg, HR - 15±6 bpm. A linear relationship between M of SBP and age (r=0.341, p< 0.001) and DBP and age (r=0.384, p<0.001) was found (difference between 20 and 77 years: SBP - 16, DBP - 12 mmHg). 2A of SBP and DBP was increasing with age up to 35 years, then the curve remained relatively flat up to 55 years (maximum at 45 years), and then it decreased again (difference between 45 and 77 years: SBP - 13mmHg, DBP - 12 mmHg). Heart rate M and 2A were age-independent. The mean values of SBP and DBP were increasing with age up to 75 years, but the night-day difference of SBP and DBP reached its maximum value at 45 years and then decreased. PMID:19436777

  1. Hospital-Based Acute Care Within 7 Days of Discharge After Outpatient Arthroscopic Shoulder Surgery.

    PubMed

    Liu, Jiabin; Flynn, David N; Liu, Wai-Man; Fleisher, Lee A; Elkassabany, Nabil M

    2017-06-16

    The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database. ER visits and IP admissions within 7 days of surgery were identified by cross-matching 2 independent Healthcare Cost and Utilization Project databases. The final cohort included 103,476 subjects. We identified 1867 (1.80%, 95% confidence interval [CI], 1.72%-1.89%) events, and the majority of these encounters were ER visits (1643, or 1.59%, 95% CI, 1.51%-1.66%). Direct IP admission after discharged was uncommon (224, or 0.22%, 95% CI, 0.19%-0.24%). The most common reasons for seeking acute care were musculoskeletal pain (23.78% of all events). Nearly half of all events (43.49%) occurred on the day of surgery or on postoperative day 1. Operative time exceeding 2 hours was associated with higher odds of requiring acute care (odds ratio [OR], 1.28; 99% CI, 1.08-1.51). High-volume surgical centers (OR, 0.67; 99% CI, 0.58-0.78) and regional anesthesia (OR, 0.72; 99% CI, 0.56-0.92) were associated with lower odds of requiring acute care. The rate of hospital-based acute care after outpatient shoulder arthroscopy was low (1.80%). Complications driving acute care visits often occurred within 1 day of surgery. Many of the events were likely related to surgery and anesthesia (eg, inadequate analgesia), suggesting that anesthesiologists may play a central role in preventing acute care visits after surgery.

  2. Clinical effects of thigh cuffs during a 7-day 6° head-down bed rest

    NASA Astrophysics Data System (ADS)

    Pavy-Le Traon, Anne; Maillet, Alain; Vasseur Clausen, Pascale; Custaud, Marc-Antoine; Alferova, Irina; Gharib, Claude; Fortrat, Jacques-Olivier

    2001-08-01

    Thigh cuffs are used by Russian cosmonauts to limit the fluid shift induced by space flight. A ground simulation using the head-down bed rest (HDBR) model was performed to assess the effects of thigh cuffs on clinical tolerance and orthostatic adaptation. 8 male healthy volunteers (32.4±1.9 years) participated twice in a 7-day HDBR — one time with thigh cuffs (worm daily from 9 am to 7 pm) (TC) and one time without (WTC). Orthostatic tolerance was assessed by a 10 minute stand test and by a LBNP test (5 min at -15, -30, -45 mmHg) before (BDC-1) and at the end of the HDBR period (R+1). Plasma volume was measured before and at the end of HDBR by the Evans blue dye dilution technique. Thigh cuffs limits headache due to fluid shift, as well as the loss in plasma volume (TC: -5.85±0.95%; WTC: -9.09±0.82%, p<0.05). The mean duration of the stand test (R+1) did not differ in the two group (TC 7.1±1.3 min; WTC 7.0±1.0 min). The increase in HR and decrease in diastolic blood pressure were slightly but significantly larger without thigh cuffs. Duration of the LBNP tests did not differ with thigh cuffs. Thigh cuffs limit the symptoms due to fluid shift and the loss in plasma volume. They partly reduced the increase in HR during orthostatic stress but had no effect on duration of orthostatic stress tests.

  3. Intermodule ventilation studies for the Space Station

    NASA Technical Reports Server (NTRS)

    Davis, Roy G.; Reuter, James L.

    1987-01-01

    This paper examines the ability of the Space Station intermodule ventilation system to maintain centralized control of CO2 removal and O2 supply. The resulting concentration gradients that will arise are calculated by assuming steady state, ideal gas, isothermal conditions, and perfect mixing of air within and between the pressurized elements. In order to estimate the degree of mixing actually obtained for a given ventilation scheme, a program has been developed based on a potential flow solution technique. Preliminary results from this study indicate that substantial short circuiting and recirculation air flow patterns could arise if a simple duct and diffuser air exchange method at the docking port interface were employed.

  4. Inspired gas humidity and temperature during mechanical ventilation with the Stephanie ventilator.

    PubMed

    Preo, Bianca L; Shadbolt, Bruce; Todd, David A

    2013-11-01

    To measure inspired gas humidity and temperature delivered by a Stephanie neonatal ventilator with variations in (i) circuit length; (ii) circuit insulation; (iii) proximal airway temperature probe (pATP) position; (iv) inspiratory temperature (offset); and (v) incubator temperatures. Using the Stephanie neonatal ventilator, inspired gas humidity and temperature were measured during mechanical ventilation at the distal inspiratory limb and 3 cm down the endotracheal tube. Measurements were made with a long or short circuit; with or without insulation of the inspiratory limb; proximal ATP (pATP) either within or external to the incubator; at two different inspiratory temperature (offset) of 37(-0.5) and 39(-2.0)°C; and at three different incubator temperatures of 32, 34.5, and 37°C. Long circuits produced significantly higher inspired humidity than short circuits at all incubator settings, while only at 32°C was the inspired temperature higher. In the long circuits, insulation further improved the inspired humidity especially at 39(-2.0)°C, while only at incubator temperatures of 32 and 37°C did insulation significantly improve inspired temperature. Positioning the pATP outside the incubator did not result in higher inspired humidity but did significantly improve inspired temperature. An inspiratory temperature (offset) of 39(-2.0)°C delivered significantly higher inspired humidity and temperature than the 37(-0.5)°C especially when insulated. Long insulated Stephanie circuits should be used for neonatal ventilation when the infant is nursed in an incubator. The recommended inspiratory temperature (offset) of 37(-0.5)°C produced inspired humidity and temperature below international standards, and we suggest an increase to 39(-2.0)°C. © 2013 John Wiley & Sons Ltd.

  5. Home Ventilator Guide

    MedlinePlus

    ... are for negative pressure ventilators currently on the markets. There is no “standard” form for specifications. American ... specifications are for bilevel ventilators currently on the markets. There is no “standard” form for specifications. American ...

  6. VENTILATION MODEL REPORT

    SciTech Connect

    V. Chipman

    2002-10-31

    The purpose of the Ventilation Model is to simulate the heat transfer processes in and around waste emplacement drifts during periods of forced ventilation. The model evaluates the effects of emplacement drift ventilation on the thermal conditions in the emplacement drifts and surrounding rock mass, and calculates the heat removal by ventilation as a measure of the viability of ventilation to delay the onset of peak repository temperature and reduce its magnitude. The heat removal by ventilation is temporally and spatially dependent, and is expressed as the fraction of heat carried away by the ventilation air compared to the fraction of heat produced by radionuclide decay. One minus the heat removal is called the wall heat fraction, or the remaining amount of heat that is transferred via conduction to the surrounding rock mass. Downstream models, such as the ''Multiscale Thermohydrologic Model'' (BSC 2001), use the wall heat fractions as outputted from the Ventilation Model to initialize their postclosure analyses.

  7. Comparison of actual tidal volume in neonatal lung model volume control ventilation using three ventilators.

    PubMed

    Toyama, H; Endo, Y; Ejima, Y; Matsubara, M; Kurosawa, S

    2011-07-01

    In neonates, small changes in tidal volumes (V(T)) may lead to complications. Previous studies have shown a significant difference between ventilator-measured tidal volume and tidal volume delivered (actual V(T)). We evaluated the accuracy of three different ventilators to deliver small V(T) during volume-controlled ventilation. We tested Servo 300, 840 ventilator and Evita 4 Neoflow ventilators with lung models simulating normal and injured neonatal lung compliance models. Gas volume delivered from the ventilator into the test circuit (V(TV)) and actual V(T) to the test lung were measured using Ventrak respiration monitors at set V(T) (30 ml). The gas volume increase of the breathing circuit was then calculated. Tidal volumes of the SV300 and PB840 in both lung models were similar to the set V(T) and the actual tidal volumes in the injured model (20.7 ml and 19.8 ml, respectively) were significantly less than that in the normal model (27.4 ml and 23.4 ml). PB840 with circuit compliance compensation could not improve the actual V(T). V(TV) of the EV4N in the normal and the injured models (37.8 ml and 46.6 ml) were markedly increased compared with set V(T), and actual V(T) were similar to set V(T) in the normal and injured model (30.2 ml and 31.9 ml, respectively). EV4N measuring V(T) close to the lung could match actual V(T) to almost the same value as the set V(T) however the gas volume of the breathing circuit was increased. If an accurate value for the patient's actual V(T) is needed, this V(T) must be measured by a sensor located between the Y-piece and the tracheal tube.

  8. VENTILATION TECHNOLOGY SYSTEMS ANALYSIS

    EPA Science Inventory

    The report gives results of a project to develop a systems analysis of ventilation technology and provide a state-of-the-art assessment of ventilation and indoor air quality (IAQ) research needs. (NOTE: Ventilation technology is defined as the hardware necessary to bring outdoor ...

  9. VENTILATION TECHNOLOGY SYSTEMS ANALYSIS

    EPA Science Inventory

    The report gives results of a project to develop a systems analysis of ventilation technology and provide a state-of-the-art assessment of ventilation and indoor air quality (IAQ) research needs. (NOTE: Ventilation technology is defined as the hardware necessary to bring outdoor ...

  10. A prospective, randomized comparison of an in-line heat moisture exchange filter and heated wire humidifiers: rates of ventilator-associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube occlusion.

    PubMed

    Kirton, O C; DeHaven, B; Morgan, J; Morejon, O; Civetta, J

    1997-10-01

    To compare the performance of an in-line heat moisture exchanging filter (HMEF) (Pall BB-100; Pall Corporation; East Hills, NY) to a conventional heated wire humidifier (H-wH) (Marquest Medical Products Inc., Englewood, Colo) in the mechanical ventilator circuit on the incidence of ventilator-associated pneumonia (VAP) and the rate of endotracheal tube occlusion. This report describes a prospective, randomized trial of 280 consecutive trauma patients in a 20-bed trauma ICU (TICU). All intubated patients not ventilated elsewhere in the medical center prior to their TICU admission were randomized to either an in-line HMEF or a H-wH in the breathing circuit. Ventilator circuits were changed routinely every 7 days, and closed system suction catheters were changed every 3 days. HMEFs were changed every 24 h, or more frequently if necessary. A specific endotracheal tube suction and lavage protocol was not employed. Patients were dropped from the HMEF group if the filter was changed more than three times a day or the patient was placed on a regimen of ultra high-frequency ventilation. The Centers for Disease Control and Prevention (CDC) criteria for diagnosis of pneumonia were used; early-onset, community-acquired pneumonia was defined if CDC criteria were met in < or =3 days, and late-onset, hospital-acquired pneumonia was defined if criteria were met in >3 days. Laboratory and chest radiograph interpretation were blinded. The patient ages ranged from 15 to 95 years in the HMEF group and 16 to 87 years in the H-wH group (p=not significant), with a mean age of 46 years and 48 years, respectively. The male to female ratio ranged between 78 to 82%/22 to 18%, respectively, and 55% of all admissions were related to blunt trauma, 40% secondary to penetrating trauma, and 5% to major burns. There was no difference in Injury Severity Score (ISS) between the two groups. Moreover, there was no significant difference in mean ISS among those who did not develop pneumonia and those

  11. Impairment of IFN-gamma response to synthetic peptides of Mycobacterium tuberculosis in a 7-day whole blood assay.

    PubMed

    Gideon, Hannah Priyadarshini; Hamilton, Melissa Shea; Wood, Kathryn; Pepper, Dominique; Oni, Tolu; Seldon, Ronnett; Banwell, Claire; Langford, Paul R; Wilkinson, Robert J; Wilkinson, Katalin A

    2013-01-01

    Studies on Mycobacterium tuberculosis (MTB) antigens are of interest in order to improve vaccine efficacy and to define biomarkers for diagnosis and treatment monitoring. The methodologies used for these investigations differ greatly between laboratories and discordant results are common. The IFN-gamma response to two well characterized MTB antigens ESAT-6 and CFP-10, in the form of recombinant proteins and synthetic peptides, was evaluated in HIV-1 uninfected persons in both long-term (7 day) and 24 hour, commercially available QuantiFERON TB Gold in Tube (QFT-GIT), whole blood assays. Our findings showed differences in the IFN-gamma response between 24 hour and 7 day cultures, with recombinant proteins inducing a significantly higher response than the peptide pools in 7 day whole blood assays. The activity of peptides and recombinant proteins did not differ in 24 hour whole blood or peripheral blood mononuclear cell (PBMC) based assays, nor in the ELISpot assay. Further analysis by SELDI-TOF mass spectrometry showed that the peptides are degraded over the course of 7 days of incubation in whole blood whilst the recombinant proteins remain intact. This study therefore demonstrates that screening antigenic candidates as synthetic peptides in long-term whole blood assays may underestimate immunogenicity.

  12. Suppurative meningitis in a 7-day-old Formosan sambar deer (Cervus unicolor swinhoei) caused by Escherichia coli

    PubMed Central

    Shyu, Ching-Lin; Lin, Cheng-Chung; Hsuan, Shih-Ling; Chiou, Shiow-Her; Chan, Jacky Peng-Wen

    2010-01-01

    This article describes the clinical and pathological features of an orphan 7-day-old, male Formosan sambar fawn that was hospitalized for treatment of weakness. The fawn had been deprived of colostrum and developed suppurative meningitis that was attributed to Escherichia coli. PMID:20514257

  13. Reliability of the International Physical Activity Questionnaire in Research Settings: Last 7-Day Self-Administered Long Form

    ERIC Educational Resources Information Center

    Levy, Susan S.; Readdy, R. Tucker

    2009-01-01

    The purpose of this study was to examine the test-retest reliability of the last 7-day long form International Physical Activity Questionnaire (Craig et al., 2003) and to examine the construct validity for the measure in a research setting. Participants were 151 male (n = 52) and female (n = 99) university students (M age = 24.15 years, SD = 5.01)…

  14. Effect of a ventilator-focused intervention on the rate of Acinetobacter baumannii infection among ventilated patients.

    PubMed

    Cohen, Regev; Shimoni, Zvi; Ghara, Riad; Ram, Ron; Ben-Ami, Ronen

    2014-09-01

    Acinetobacter baumannii is a leading cause of ventilator-associated pneumonia, often as a result of ventilator equipment contamination. Evidence-based guidance on optimal care of ventilator equipment to prevent infection is lacking. Here, we report on a significant and persistent reduction in A baumannii infection rates achieved by introducing a strict policy on ventilator care. We implemented an institution-wide ventilator care policy that included routine exchange of breathing circuits and external bacterial filters (every 7-14 days) and replacement followed by routine sterilization of internal bacterial filters (every 4-8 weeks). We analyzed sputum cultures and patient outcomes among ventilated patients before and after the intervention. Between January 2012 and March 2013, 321 patients ventilated for more than 3 days comprised the study cohort. Health care-associated A baumannii acquisition was significantly reduced during the postintervention period (33% vs 16%; odds ratio, 0.39; 95% confidence interval, 0.23-0.67; P = .0008). Additionally, the median time to A baumannii acquisition was significantly longer postintervention (59 vs 21 days; P < .0001). A baumannii ventilator-associated pneumonia risk was also reduced postintervention (odds ratio, 0.39; P = .005). Implementing a stricter standard of ventilator care than that currently defined in published guidelines can significantly decrease health care-associated A baumannii acquisition and related adverse outcomes among ventilated patients. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  15. ADDER CIRCUIT

    DOEpatents

    Jacobsohn, D.H.; Merrill, L.C.

    1959-01-20

    An improved parallel addition unit is described which is especially adapted for use in electronic digital computers and characterized by propagation of the carry signal through each of a plurality of denominationally ordered stages within a minimum time interval. In its broadest aspects, the invention incorporates a fast multistage parallel digital adder including a plurality of adder circuits, carry-propagation circuit means in all but the most significant digit stage, means for conditioning each carry-propagation circuit during the time period in which information is placed into the adder circuits, and means coupling carry-generation portions of thc adder circuit to the carry propagating means.

  16. DEMAND CONTROLLED VENTILATION AND CLASSROOM VENTILATION

    SciTech Connect

    Fisk, William J.; Mendell, Mark J.; Davies, Molly; Eliseeva, Ekaterina; Faulkner, David; Hong, Tienzen; Sullivan, Douglas P.

    2014-01-06

    This document summarizes a research effort on demand controlled ventilation and classroom ventilation. The research on demand controlled ventilation included field studies and building energy modeling. Major findings included: ? The single-location carbon dioxide sensors widely used for demand controlled ventilation frequently have large errors and will fail to effectively control ventilation rates (VRs).? Multi-location carbon dioxide measurement systems with more expensive sensors connected to multi-location sampling systems may measure carbon dioxide more accurately.? Currently-available optical people counting systems work well much of the time but have large counting errors in some situations. ? In meeting rooms, measurements of carbon dioxide at return-air grilles appear to be a better choice than wall-mounted sensors.? In California, demand controlled ventilation in general office spaces is projected to save significant energy and be cost effective only if typical VRs without demand controlled ventilation are very high relative to VRs in codes. Based on the research, several recommendations were developed for demand controlled ventilation specifications in the California Title 24 Building Energy Efficiency Standards.The research on classroom ventilation collected data over two years on California elementary school classrooms to investigate associations between VRs and student illness absence (IA). Major findings included: ? Median classroom VRs in all studied climate zones were below the California guideline, and 40percent lower in portable than permanent buildings.? Overall, one additional L/s per person of VR was associated with 1.6percent less IA. ? Increasing average VRs in California K-12 classrooms from the current average to the required level is estimated to decrease IA by 3.4percent, increasing State attendance-based funding to school districts by $33M, with $6.2 M in increased energy costs. Further VR increases would provide additional benefits

  17. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery.

    PubMed

    Futier, Emmanuel; Constantin, Jean-Michel; Paugam-Burtz, Catherine; Pascal, Julien; Eurin, Mathilde; Neuschwander, Arthur; Marret, Emmanuel; Beaussier, Marc; Gutton, Christophe; Lefrant, Jean-Yves; Allaouchiche, Bernard; Verzilli, Daniel; Leone, Marc; De Jong, Audrey; Bazin, Jean-Etienne; Pereira, Bruno; Jaber, Samir

    2013-08-01

    Lung-protective ventilation with the use of low tidal volumes and positive end-expiratory pressure is considered best practice in the care of many critically ill patients. However, its role in anesthetized patients undergoing major surgery is not known. In this multicenter, double-blind, parallel-group trial, we randomly assigned 400 adults at intermediate to high risk of pulmonary complications after major abdominal surgery to either nonprotective mechanical ventilation or a strategy of lung-protective ventilation. The primary outcome was a composite of major pulmonary and extrapulmonary complications occurring within the first 7 days after surgery. The two intervention groups had similar characteristics at baseline. In the intention-to-treat analysis, the primary outcome occurred in 21 of 200 patients (10.5%) assigned to lung-protective ventilation, as compared with 55 of 200 (27.5%) assigned to nonprotective ventilation (relative risk, 0.40; 95% confidence interval [CI], 0.24 to 0.68; P=0.001). Over the 7-day postoperative period, 10 patients (5.0%) assigned to lung-protective ventilation required noninvasive ventilation or intubation for acute respiratory failure, as compared with 34 (17.0%) assigned to nonprotective ventilation (relative risk, 0.29; 95% CI, 0.14 to 0.61; P=0.001). The length of the hospital stay was shorter among patients receiving lung-protective ventilation than among those receiving nonprotective ventilation (mean difference, -2.45 days; 95% CI, -4.17 to -0.72; P=0.006). As compared with a practice of nonprotective mechanical ventilation, the use of a lung-protective ventilation strategy in intermediate-risk and high-risk patients undergoing major abdominal surgery was associated with improved clinical outcomes and reduced health care utilization. (IMPROVE ClinicalTrials.gov number, NCT01282996.).

  18. Blood pressure circadian pattern and physical exercise assessment by accelerometer and 7-day physical activity recall scale.

    PubMed

    García-Ortiz, Luis; Recio-Rodríguez, José I; Puig-Ribera, Anna; Lema-Bartolomé, Jorge; Ibáñez-Jalón, Elisa; González-Viejo, Natividad; Guenaga-Saenz, Nahia; Agudo-Conde, Cristina; Patino-Alonso, Maria C; Gomez-Marcos, Manuel A

    2014-05-01

    The relationship between regular physical activity, measured objectively and by self-report, and the circadian pattern of 24-hour ambulatory arterial blood pressure (BP) has not been clarified. We performed a cross-sectional study in a cohort of healthy patients. We included 1,345 patients from the EVIDENT study (mean age 55 ± 14 years; 59.3% women). Physical activity was assessed using the 7-day physical activity recall (PAR) questionnaire (metabolic equivalents (MET)/hour/week) and the Actigraph GT3X accelerometer (counts/minute) for 7 days; ambulatory arterial BP was measured with a radial tonometer (B-pro device). The dipper-pattern patients showed a higher level of activity than nondipper patients, as assessed by accelerometer and 7-day PAR. Physical activity measures correlated positively with the percent drop in systolic BP (SBP; ρ = 0.19 to 0.11; P < 0.01) and negatively with the systolic and diastolic sleep to wake ratios (ρ = -0.10 to -0.18; P < 0.01) and heart rate (ρ = -0.13; P < 0.01). In logistic regression, considering the circadian pattern (1, dipper; 0, nondipper) as the dependent variable, the odds ratio of the third tertile of counts/minute was 1.79 (95% confidence interval [CI], 1.35-2.38; P < 0.01) and of MET/hour/week was 1.33 (95% CI, 1.01-1.75; P = 0.04) after adjustment for confounding variables. Physical activity, as evaluated by both the accelerometer and the 7-day PAR, was associated with a more marked nocturnal BP dip and, accordingly, a lower SBP and diastolic BP sleep to wake ratio. Clinical Trials.gov Identifier: NCT01083082.

  19. Elevated tumour markers are normalized in most patients with pseudomyxoma peritonei 7 days after complete tumour removal.

    PubMed

    Di Fabio, F; Aston, W; Mohamed, F; Chandrakumaran, K; Cecil, T; Moran, B

    2015-08-01

    Elevation of the preoperative tumour markers in pseudomyxoma peritonei (PMP) is common and is a risk factor for recurrence. There has, however, been no documentation of the effect of complete tumour removal on tumour markers levels after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of the study was to compare the tumour markers 7 days after surgery in patients with elevated preoperative levels. This was an observational prospective study of patients with PMP of appendiceal origin treated in one of the UK National Referral Centres for this condition. Thirty patients [median age = 61 (range: 31-74) years; six men] with an elevated preoperative level of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA-125) and/or carbohydrate antigen 19-9 (CA19-9) underwent repeated estimation, 7 days after CRS and HIPEC for PMP. The median preoperative CEA level of 12 μg/l fell to 0.75 μg/l postoperatively (P < 0.0001), CA-125 fell from 45 to 31 kU/l (P = 0.183) and CA19-9 fell from 134 to 37 kU/l (P = 0.003). The CEA was raised in 22 (73%) of 30 patients preoperatively and in two (7%) of 30 patients 7 days after surgery (P < 0.0001). The corresponding data for CA-125 were 18 (60%) and 13 (43%) (P = 0.196) and for CA19-9 they were 24 (80%) and 16 (53%) (P = 0.028). This is the first documentation of a reduction or normalization of CEA 7 days after CRS, but not for CA19-9 or CA-125. This may indicate completeness of surgical resection and could aid selection for adjuvant therapy and predict prognosis. Long-term follow-up is, however, necessary to determine the significance of this observation. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

  20. Effects of a 7-day treatment with midodrine in non-azotemic cirrhotic patients with and without ascites.

    PubMed

    Kalambokis, Georgios; Fotopoulos, Andreas; Economou, Michalis; Pappas, Konstantinos; Tsianos, Epameinondas V

    2007-02-01

    Splanchnic arterial vasodilatation has been causally related with hyperdynamic circulation and impaired natriuresis in advanced cirrhosis and has also been suggested to be responsible for the subtle sodium retention in pre-ascitic cirrhosis. This study evaluated the effects of a 7-day treatment with the alpha1-adrenergic agonist midodrine in non-azotemic cirrhotic patients with and without ascites. Thirty-nine cirrhotic patients were studied at baseline and 7 days after administration of oral midodrine 10mg, t.i.d. (11 without and 12 with ascites) or placebo (8 without and 8 with ascites). A significant increase in urine sodium excretion was noted after midodrine administration in patients without and with ascites, in line with significant increases in mean arterial pressure and systemic vascular resistance, and significant decreases in cardiac output and heart rate. Significant increases in glomerular filtration rate, filtration fraction, and urine volume and significant decreases in plasma renin activity and aldosterone were observed in patients with ascites. Placebo had no effect in any study group. The administration of midodrine for 7 days improves systemic haemodynamics and sodium excretion in non-azotemic cirrhotic patients without or with ascites. In patients with ascites, but not in those without ascites, these effects are associated with a suppression of the activity of the renin-angiotensin-aldosterone system, suggesting that the increase in natriuresis is related to the improvement in the effective arterial blood volume.

  1. Effects of a paraspinal-lumbar tape application during 7 days on the perceived area of tape contact.

    PubMed

    Funk, Stefan; Finke, Roy; Zeh, Stefan; Siebert, Tobias; Puta, Christian

    2017-05-01

    The study aimed to investigate the changes of the perceived area of tape contact during a lumbar tape application that lasted 7 days. Single group, repeated measures study. University research laboratory. Twenty-three healthy collegiate students in sports science. Perceived area of tape contact was collected by preparing a drawing of their individual perceived tape outline into a printed body image. Measurements were obtained immediately after fixation of the tape (day 0), at day 3 and day 7 during application and 5 min after the release of the application (day 7). There was no significant change of the perceived area of tape contact after 3 days of tape application. A significant decrease in the perceived area of tape contact was detected 7 days after application (p < 0.05) and after detaching the tape (p < 0.01) compared to the first measurement. Our results indicate that the perception of the area of tape contact of healthy sport students is decreased at 7 days. This effect could not be observed at 3 days. These results provide relevant information for the use of elastic tapes concerning the duration of application in medical therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Prediction of glycated hemoglobin levels at 3 months after metabolic surgery based on the 7-day plasma metabolic profile.

    PubMed

    Kwon, Hyuk Nam; Lee, Yeon Ji; Kang, Ju-Hee; Choi, Ji-Ho; An, Yong Jin; Kang, Sunmi; Lee, Dae Hyun; Suh, Young Ju; Heo, Yoonseok; Park, Sunghyouk

    2014-01-01

    Metabolic surgery has been shown to provide better glycemic control for type 2 diabetes than conventional therapies. Still, the outcomes of the surgery are variable, and prognostic markers reflecting the metabolic changes by the surgery are yet to be established. NMR-based plasma metabolomics followed by multivariate regression was used to test the correlation between the metabolomic profile at 7-days after surgery and glycated hemoglobin (HbA1c) levels at 3-months (and up to 12 months with less patients), and to identify the relevant markers. Metabolomic profiles at 7-days could differentiate the patients according to the HbA1c improvement status at 3-months. The HbA1c values were predicted based on the metabolomics profile with partial least square regression, and found to be correlated with the observed values. Metabolite analysis suggested that 3-Hydroxybutyrate (3-HB) and glucose contributes to this prediction, and the [3-HB]/[glucose] exhibited a modest to good correlation with the HbA1c level at 3-months. The prediction of 3-month HbA1c using 7-day metabolomic profile and the suggested new criterion [3-HB]/[glucose] could augment current prognostic modalities and help clinicians decide if drug therapy is necessary.

  3. Emergency ventilation with a Chevalier Jackson's metal tracheostomy tube.

    PubMed

    Syed, Kamran A; Paul, Roshna R; Varghese, Ajoy M; Joseph, Neenu A

    2014-05-01

    Chevalier Jackson's metal tracheostomy tube is the oldest tracheostomy tube and has survived to the present day. This is probably because it is easy to use and cost-effective. However its biggest limitation is that it lacks provision to connect to a ventilating circuit in an emergency. Here we describe a simple and effective technique for ventilation with Chevalier Jackson's metal tracheostomy tube. Ventilation can be achieved by connecting the tracheostomy tube to an appropriate size universal 15mm endotracheal tube connector. We have also worked out a formula for selection of appropriate connector for various sizes of tracheostomy tube.

  4. A simple circuit to deliver bubbling CPAP.

    PubMed

    Kaur, Charanjit; Sema, Akatoli; Beri, Rajbir S; Puliyel, Jacob M

    2008-04-01

    Nasal continuous positive airway pressure (CPAP), especially bubbling CPAP, is known to reduce the need for more invasive ventilation. We here describe a circuit that can deliver bubbling CPAP in resource poor settings. We describe how the oxygen concentration can be altered from 98% to 21% oxygen using this system. Addition of a humidifier in the circuit has the effect of reducing the oxygen concentration by 1 to 5%. The cost of putting together the system is approximately Rs 5000.

  5. Ventilation Model Report

    SciTech Connect

    V. Chipman; J. Case

    2002-12-20

    The purpose of the Ventilation Model is to simulate the heat transfer processes in and around waste emplacement drifts during periods of forced ventilation. The model evaluates the effects of emplacement drift ventilation on the thermal conditions in the emplacement drifts and surrounding rock mass, and calculates the heat removal by ventilation as a measure of the viability of ventilation to delay the onset of peak repository temperature and reduce its magnitude. The heat removal by ventilation is temporally and spatially dependent, and is expressed as the fraction of heat carried away by the ventilation air compared to the fraction of heat produced by radionuclide decay. One minus the heat removal is called the wall heat fraction, or the remaining amount of heat that is transferred via conduction to the surrounding rock mass. Downstream models, such as the ''Multiscale Thermohydrologic Model'' (BSC 2001), use the wall heat fractions as outputted from the Ventilation Model to initialize their post-closure analyses. The Ventilation Model report was initially developed to analyze the effects of preclosure continuous ventilation in the Engineered Barrier System (EBS) emplacement drifts, and to provide heat removal data to support EBS design. Revision 00 of the Ventilation Model included documentation of the modeling results from the ANSYS-based heat transfer model. Revision 01 ICN 01 included the results of the unqualified software code MULTIFLUX to assess the influence of moisture on the ventilation efficiency. The purposes of Revision 02 of the Ventilation Model are: (1) To validate the conceptual model for preclosure ventilation of emplacement drifts and verify its numerical application in accordance with new procedural requirements as outlined in AP-SIII-10Q, Models (Section 7.0). (2) To satisfy technical issues posed in KTI agreement RDTME 3.14 (Reamer and Williams 2001a). Specifically to demonstrate, with respect to the ANSYS ventilation model, the adequacy of

  6. Aerosol therapy in patients receiving noninvasive positive pressure ventilation.

    PubMed

    Dhand, Rajiv

    2012-04-01

    In selected patients, noninvasive positive pressure ventilation (NIPPV) with a facemask is now commonly employed as the first choice for providing mechanical ventilation in the intensive care unit (ICU). Aerosol therapy for treatment of acute or acute-on-chronic respiratory failure in this setting may be delivered by pressurized metered-dose inhaler (pMDI) with a chamber spacer and facemask or nebulizer and facemask. This article reviews the host of factors influencing aerosol delivery with these devices during NIPPV. These factors include (1) the type of ventilator, (2) mode of ventilation, (3) circuit conditions, (4) type of interface, (5) type of aerosol generator, (6) drug-related factors, (7) breathing parameters, and (8) patient-related factors. Despite the impediments to efficient aerosol delivery because of continuous gas flow, high inspiratory flow rates, air leaks, circuit humidity, and patient-ventilator asynchrony, significant therapeutic effects are achieved after inhaled bronchodilator administration to patients with asthma and chronic obstructive pulmonary disease. Similarly to invasive mechanical ventilation, careful attention to the technique of drug administration is required to optimize therapeutic effects of inhaled therapies during NIPPV. Assessment of the patient's ability to tolerate a facemask, the level of respiratory distress, hemodynamic status, and synchronization of aerosol generation with inspiratory airflow are important factors contributing to the success of aerosol delivery during NIPPV. Further research into novel delivery methods, such as the use of NIPPV with nasal cannulae, could enhance the efficiency, ease of use, and reproducibility of inhalation therapy during noninvasive ventilation.

  7. New generation ventilators.

    PubMed

    Bersten, A D; Skowronski, G A; Oh, T E

    1986-08-01

    Desirable features of new generation intensive care ventilators include the ability to ventilate a wide range of patient sizes, an uncomplicated control panel, an appropriate but not excessive variety of ventilatory patterns, adequate patient monitoring and alarm functions, and simplicity of cleaning and routine maintenance. Examples of currently available ventilators include the Servo 900-C, CPU-1, Engstrom Erica, Bear 5, Drager EV-A and Hamilton Veolar. The incorporation of microcomputer control into some of these ventilators has resulted in improved flexibility and a limited number of automatic responses to detected patient changes. However, the function of components provided to allow spontaneous ventilation, such as demand valves, requires considerable improvement. Current trends in ventilator design include further refinement of computer control and the provision of graphic displays showing the results of continuous sophisticated analysis of respiratory function. The extent to which these developments will prove clinically useful will require careful evaluation.

  8. Protective garment ventilation system

    NASA Technical Reports Server (NTRS)

    Lang, R. (Inventor)

    1970-01-01

    A method and apparatus for ventilating a protective garment, space suit system, and/or pressure suits to maintain a comfortable and nontoxic atmosphere within is described. The direction of flow of a ventilating and purging gas in portions of the garment may be reversed in order to compensate for changes in environment and activity of the wearer. The entire flow of the ventilating gas can also be directed first to the helmet associated with the garment.

  9. Mechanical ventilation in children.

    PubMed

    Kendirli, Tanil; Kavaz, Asli; Yalaki, Zahide; Oztürk Hişmi, Burcu; Derelli, Emel; Ince, Erdal

    2006-01-01

    Mechanical ventilation can be lifesaving, but > 50% of complications in conditions that require intensive care are related to ventilatory support, particularly if it is prolonged. We retrospectively evaluated the medical records of patients who had mechanical ventilation in the Pediatric Intensive Care Unit (PICU) during a follow-up period between January 2002-May 2005. Medical records of 407 patients were reviewed. Ninety-one patients (22.3%) were treated with mechanical ventilation. Ages of all patients were between 1-180 (median: 8) months. The mechanical ventilation time was 18.8 +/- 14.1 days. Indication of mechanical ventilation could be divided into four groups as respiratory failure (64.8%), cardiovascular failure (19.7%), central nervous system disease (9.8%) and safety airway (5.4%). Tracheostomy was performed in four patients. The complication ratio of mechanically ventilated children was 42.8%, and diversity of complications was as follows: 26.3% atelectasia, 17.5% ventilator-associated pneumonia, 13.1% pneumothorax, 5.4% bleeding, 4.3% tracheal edema, and 2.1% chronic lung disease. The mortality rate of mechanically ventilated patients was 58.3%, but the overall mortality rate in the PICU was 12.2%. In conclusion, there are few published epidemiological data on the follow-up results and mortality in infants and children who are mechanically ventilated.

  10. Noninvasive ventilation in trauma

    PubMed Central

    Karcz, Marcin K; Papadakos, Peter J

    2015-01-01

    Trauma patients are a diverse population with heterogeneous needs for ventilatory support. This requirement depends mainly on the severity of their ventilatory dysfunction, degree of deterioration in gaseous exchange, any associated injuries, and the individual feasibility of potentially using a noninvasive ventilation approach. Noninvasive ventilation may reduce the need to intubate patients with trauma-related hypoxemia. It is well-known that these patients are at increased risk to develop hypoxemic respiratory failure which may or may not be associated with hypercapnia. Hypoxemia in these patients is due to ventilation perfusion mismatching and right to left shunt because of lung contusion, atelectasis, an inability to clear secretions as well as pneumothorax and/or hemothorax, all of which are common in trauma patients. Noninvasive ventilation has been tried in these patients in order to avoid the complications related to endotracheal intubation, mainly ventilator-associated pneumonia. The potential usefulness of noninvasive ventilation in the ventilatory management of trauma patients, though reported in various studies, has not been sufficiently investigated on a large scale. According to the British Thoracic Society guidelines, the indications and efficacy of noninvasive ventilation treatment in respiratory distress induced by trauma have thus far been inconsistent and merely received a low grade recommendation. In this review paper, we analyse and compare the results of various studies in which noninvasive ventilation was applied and discuss the role and efficacy of this ventilator modality in trauma. PMID:25685722

  11. Influences of Duration of Inspiratory Effort, Respiratory Mechanics, and Ventilator Type on Asynchrony With Pressure Support and Proportional Assist Ventilation.

    PubMed

    Vasconcelos, Renata S; Sales, Raquel P; Melo, Luíz H de P; Marinho, Liégina S; Bastos, Vasco Pd; Nogueira, Andréa da Nc; Ferreira, Juliana C; Holanda, Marcelo A

    2017-05-01

    Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0.5, 1.0, 1.5, and 2.0 s. The Auto-Trak system was studied in ventilators when available. Outcome measures included inspiratory trigger delay, expiratory trigger asynchrony, and tidal volume (VT). Inspiratory trigger delay was greater in the obstructive respiratory mechanics profile and greatest with a effort of 2.0 s (160 ms); cycling asynchrony, particularly delayed cycling, was common in the obstructive profile, whereas the restrictive profile was associated with premature cycling. In comparison with PSV, PAV+ improved patient-ventilator synchrony, with a shorter triggering delay (28 ms vs 116 ms) and no cycling asynchrony in the restrictive profile. VT was lower with PAV+ than with PSV (630 mL vs 837 mL), as it was with the single-limb circuit ventilator (570 mL vs 837 mL). PAV+ mode was associated with longer cycling delays than were the other ventilation modes, especially for the obstructive profile and higher effort values. Auto-Trak eliminated automatic triggering. Mechanical ventilation asynchrony was influenced by effort, respiratory mechanics, ventilator type, and ventilation mode. In PSV mode, delayed cycling was associated with shorter effort in obstructive respiratory mechanics profiles, whereas premature cycling was more common with longer effort and a restrictive profile. PAV+ prevented premature cycling but not delayed cycling, especially in obstructive respiratory mechanics profiles

  12. Ventilatory failure, ventilator support, and ventilator weaning.

    PubMed

    Tobin, Martin J; Laghi, Franco; Jubran, Amal

    2012-10-01

    The development of acute ventilatory failure represents an inability of the respiratory control system to maintain a level of respiratory motor output to cope with the metabolic demands of the body. The level of respiratory motor output is also the main determinant of the degree of respiratory distress experienced by such patients. As ventilatory failure progresses and patient distress increases, mechanical ventilation is instituted to help the respiratory muscles cope with the heightened workload. While a patient is connected to a ventilator, a physician's ability to align the rhythm of the machine with the rhythm of the patient's respiratory centers becomes the primary determinant of the level of rest accorded to the respiratory muscles. Problems of alignment are manifested as failure to trigger, double triggering, an inflationary gas-flow that fails to match inspiratory demands, and an inflation phase that persists after a patient's respiratory centers have switched to expiration. With recovery from disorders that precipitated the initial bout of acute ventilatory failure, attempts are made to discontinue the ventilator (weaning). About 20% of weaning attempts fail, ultimately, because the respiratory controller is unable to sustain ventilation and this failure is signaled by development of rapid shallow breathing. Substantial advances in the medical management of acute ventilatory failure that requires ventilator assistance are most likely to result from research yielding novel insights into the operation of the respiratory control system.

  13. DARPA 7-Day Challenge

    DTIC Science & Technology

    2014-03-17

    live fire challenge. ....................................... 54 Figure 62: Schedule for Live Fire Test with B. pseudomallei strain 1028...currently being investigated in clinical trials for the treatment of AIDS, hepatitis C and cancer 3 . However, antigen delivery problems have...from Ac-DEX are pH- sensitive and degrade quicker in lysosomal pH (~ 5) compared to physiological pH (7.4). Beyond its performance in vaccine

  14. Review of Residential Ventilation Technologies

    SciTech Connect

    Armin Rudd

    2005-08-30

    This paper reviews current and potential ventilation technologies for residential buildings, including a variety of mechanical systems, natural ventilation, and passive ventilation. with particular emphasis on North American climates and construction.

  15. Automated preparation of whole blood-derived platelets suspended in two different platelet additive solutions and stored for 7 days.

    PubMed

    Cid, Joan; Magnano, Laura; Molina, Patricia; Diaz-Ricart, Maribel; Martínez, Nuria; Maymó, Rosa M; Puig, Lluís; Lozano, Miguel; Escolar, Ginés; Galán, Ana M

    2014-02-01

    The Atreus system (Terumo BCT) automates the preparation of blood components from whole blood donations. Intermediate platelet (PLT) products can be pooled manually or with the OrbiSac (Terumo BCT) and suspended in different PLT additive solutions (PASs) to obtain PLT concentrates (PCs). The aim of our study was to compare the in vitro PLT quality of PCs obtained with either the Atreus 2C+ and the OrbiSac or the Atreus 3C and suspended in PAS-II or PAS-IIIM during storage for up to 7 days. We prepared eight PCs from buffy coats obtained with Atreus 2C+, pooled with the OrbiSac, and suspended in PAS-II and eight PCs from interim PLT units obtained with the Atreus 3C and suspended either in PAS-II or in PAS-IIIM. We measured volume, PLT content, and mean PLT component and performed metabolic assays (pH, glucose, lactate, pO₂, and pCO₂) and flow cytometry analyses (GPIb, GPIIbIIIa, GPIV, CD62P, CD63, von Willebrand factor [vWF], fibrinogen, Factor V, and annexin V). PCs prepared with the Atreus 3C showed lower volume and higher PLT concentration when compared with PCs prepared with the Atreus 2C+ and the OrbiSac (p < 0.05). Glucose consumption rate and the expression of CD62P, CD63, and vWF were lower in PCs suspended in PAS-IIIM when compared with PCs suspended in PAS-II (p < 0.05). PCs prepared with the Atreus 3C and suspended in PAS-IIIM preserve satisfactorily the in vitro PLT quality during 7-day storage. PLT activation during a 7-day storage period was lower when the storage solution was PAS-IIIM in comparison with PAS-II. © 2013 American Association of Blood Banks.

  16. Comparing a 7-day diary vs. 24 h-recall for estimating fluid consumption in overweight and obese Mexican women.

    PubMed

    Hernández-Cordero, Sonia; López-Olmedo, Nancy; Rodríguez-Ramírez, Sonia; Barquera-Cervera, Simón; Rivera-Dommarco, Juan; Popkin, Barry

    2015-10-07

    High intake of sugar-sweetened beverages (SSB) is linked to increased weight, energy intake, and diabetes. Even though the increasing interest on beverages and water intake, there are few dietary tools carefully validated. The purpose of this paper is to compare a fluid intake 7-day diary against a 24-h recall questionnaire to estimate the fluid consumption in overweight and obese women participating in a randomized controlled trial in Mexico. This cross-sectional study explored the correlation of reported fluid consumption between two methods: 3-day 24-hr recalls and 7-day diary beverage registry in overweight and obese Mexican women aged 18-45 y (n = 190). There was no difference on median estimated volume (mL/d), nor the median estimated energy (kcal/d) from total beverage consumption registered by the two dietary tools. The crude and rank correlation among the two dietary instruments was high for total fluid consumption in mL/d r = 0.7, p < 0.001 (crude and rank correlation) and for fluid consumption measured as energy intake: r = 0.7; p < 0.001 crude, and r = 0.5; p < 0.001 rank correlation. By type of beverage, the more meaningful rank correlations were for fluid intake in: mL/d, water, alcohol beverages, and SSB; and in kcal/d, alcohol beverages and SSBs (rank correlation ≥ 0.6). Overall, the 7-day diary showed high and strong rank correlations with that reported in the 24-h recall, suggesting that the diary method is a valid dietary tool to evaluate total fluid, water and SSB intake in this population.

  17. Biopsy Specimens Obtained 7 Days After Starting Chemoradiotherapy (CRT) Provide Reliable Predictors of Response to CRT for Rectal Cancer

    SciTech Connect

    Suzuki, Toshiyuki; Sadahiro, Sotaro; Tanaka, Akira; Okada, Kazutake; Kamata, Hiroko; Kamijo, Akemi; Murayama, Chieko; Akiba, Takeshi; Kawada, Shuichi

    2013-04-01

    Purpose: Preoperative chemoradiation therapy (CRT) significantly decreases local recurrence in locally advanced rectal cancer. Various biomarkers in biopsy specimens obtained before CRT have been proposed as predictors of response. However, reliable biomarkers remain to be established. Methods and Materials: The study group comprised 101 consecutive patients with locally advanced rectal cancer who received preoperative CRT with oral uracil/tegafur (UFT) or S-1. We evaluated histologic findings on hematoxylin and eosin (H and E) staining and immunohistochemical expressions of Ki67, p53, p21, and apoptosis in biopsy specimens obtained before CRT and 7 days after starting CRT. These findings were contrasted with the histologic response and the degree of tumor shrinkage. Results: In biopsy specimens obtained before CRT, histologic marked regression according to the Japanese Classification of Colorectal Carcinoma (JCCC) criteria and the degree of tumor shrinkage on barium enema examination (BE) were significantly greater in patients with p21-positive tumors than in those with p21-negative tumors (P=.04 and P<.01, respectively). In biopsy specimens obtained 7 days after starting CRT, pathologic complete response, histologic marked regression according to both the tumor regression criteria and JCCC criteria, and T downstaging were significantly greater in patients with apoptosis-positive and p21-positive tumors than in those with apoptosis-negative (P<.01, P=.02, P=.01, and P<.01, respectively) or p21-negative tumors (P=.03, P<.01, P<.01, and P=.02, respectively). The degree of tumor shrinkage on both BE as well as MRI was significantly greater in patients with apoptosis-positive and with p21-positive tumors than in those with apoptosis-negative or p21-negative tumors, respectively. Histologic changes in H and E-stained biopsy specimens 7 days after starting CRT significantly correlated with pathologic complete response and marked regression on both JCCC and tumor

  18. 7-day weighed food diaries suggest patients with hereditary hemorrhagic telangiectasia may spontaneously modify their diet to avoid nosebleed precipitants.

    PubMed

    Finnamore, Helen; Silva, B Maneesha; Hickson, B Mary; Whelan, Kevin; Shovlin, Claire L

    2017-03-28

    Hereditary hemorrhagic telangiectasia (HHT) poses substantial burdens due to nosebleeds and iron deficiency resulting from recurrent hemorrhagic iron losses. Recent studies by our group found surprising links between HHT nosebleeds and certain food groups. In this letter, we report 7-day weighed food diary assessments of an unselected group of 25 UK patients with HHT whose nosebleeds ranged from mild to severe (median epistaxis severity score 4.66, range 0.89- 9.11). The diaries provide evidence that food items most commonly reported to provoke nosebleeds were ingested by fewer HHT patients, compared to food items less commonly reported to provoke nosebleeds (chi-squared p <0.001).

  19. Multifamily Ventilation Retrofit Strategies

    SciTech Connect

    Ueno, K.; Lstiburek, J.; Bergey, D.

    2012-12-01

    In multifamily buildings, central ventilation systems often have poor performance, overventilating some portions of the building (causing excess energy use), while simultaneously underventilating other portions (causing diminished indoor air quality). BSC and Innova Services Corporation performed a series of field tests at a mid-rise test building undergoing a major energy audit and retrofit, which included ventilation system upgrades.

  20. Guide to Home Ventilation

    SciTech Connect

    2010-10-01

    A fact sheet from the U.S. Department of Energy's Office of Energy Efficiency and Renewable Energy: Ventilation refers to the exchange of indoor and outdoor air. Without proper ventilation, an otherwise insulated and airtight house will seal in harmful pollutants, such as carbon monoxide, and moisture that can damage a house.

  1. GATING CIRCUITS

    DOEpatents

    Merrill, L.C.

    1958-10-14

    Control circuits for vacuum tubes are described, and a binary counter having an improved trigger circuit is reported. The salient feature of the binary counter is the application of the input signal to the cathode of each of two vacuum tubes through separate capacitors and the connection of each cathode to ground through separate diodes. The control of the binary counter is achieved in this manner without special pulse shaping of the input signal. A further advantage of the circuit is the simplicity and minimum nuruber of components required, making its use particularly desirable in computer machines.

  2. MULTIPLIER CIRCUIT

    DOEpatents

    Thomas, R.E.

    1959-01-20

    An electronic circuit is presented for automatically computing the product of two selected variables by multiplying the voltage pulses proportional to the variables. The multiplier circuit has a plurality of parallel resistors of predetermined values connected through separate gate circults between a first input and the output terminal. One voltage pulse is applied to thc flrst input while the second voltage pulse is applied to control circuitry for the respective gate circuits. Thc magnitude of the second voltage pulse selects the resistors upon which the first voltage pulse is imprcssed, whereby the resultant output voltage is proportional to the product of the input voltage pulses

  3. Estimating children's eating habits. Validity of a questionnaire measuring food frequency compared to a 7-day record.

    PubMed

    Blom, L; Lundmark, K; Dahlquist, G; Persson, L A

    1989-11-01

    A questionnaire measuring food frequency was validated against 7-day records of food intake in a group of 30 children, 2-16 years of age. Special emphasis was given to the ability of the questionnaire to estimate frequency of intake of foods of particular interest in diabetes mellitus. Fifteen children had insulin-dependent diabetes; 15 were healthy. Comparison of the two methods regarding frequency of foods with high content of sucrose, protein, fat, fibres, nitrite or vitamin C showed a correlation of 0.52-0.76. The frequency of intake of some staple foods was often overestimated by the questionnaire, while the frequency of meat, sausage and some sweet snacks was underestimated. The use of the questionnaire to identify high or low consumers of the mentioned nutrients showed a rather low sensitivity (0.38-0.50), but a high specificity (0.86-1.0) when compared with results of the 7-day record. In our limited sample of subjects no systematic differences were found comparing sexes or diabetic and healthy children. A food frequency questionnaire may, in spite of some important reservations, be a useful tool for screening purposes when more time-consuming and resource-demanding methods cannot be used.

  4. Characterization of a 7 day 17 beta-estradiol transdermal delivery system: pharmacokinetics in healthy postmenopausal women.

    PubMed

    Boyd, R A; Zegarac, E A; Eldon, M A; Sedman, A J; Forgue, S T

    1996-08-01

    To assess the delivery characteristics of a new 7 day 17 beta-estradiol transdermal delivery system (TDS), estradiol and estrone pharmacokinetics were evaluated following a single 7 d application of one TDS or two TDSs in 24 healthy, postmenopausal women in a nonblind, randomized, two-period crossover study. Serial blood samples and total urine output were collected before (baseline measurement of endogenous hormone) and during TDS application, and for 24 h (urine) or 72 h (blood) following TDS removal. Serum was assayed for estradiol and estrone by a validated radioimmunoassay (RIA) method. The combined amounts of estradiol and its conjugates, and estrone and its conjugates in urine were determined by validated RIA methods. Overall, one or two estradiol TDSs were well tolerated by healthy, postmenopausal female volunteers. Estradiol absorption from the TDS was characterized by a zero-order process and was dose proportional, resulting in average steady-state serum estradiol concentrations of 16 and 33 pg mL-1 above baseline during the 7 d application of one and two TDSs, respectively. Parallel but smaller increases in serum estrone concentrations were observed, resulting in an increase in the serum estradiol/estrone concentration ratio from approximately 0.2 at baseline to median values of 0.64 and 0.88 during application of one and two TDSs, respectively. The 7 day 17 beta-estradiol TDS delivered a nominal estradiol dose of 0.02 mg/24 h during the intended wear period.

  5. Relative efficiencies of the Burkard 7-Day, Rotorod and Burkard Personal Samplers for Poaceae and Urticaceae pollen under field conditions.

    PubMed

    Peel, Robert G; Kennedy, Roy; Smith, Matt; Hertel, Ole

    2014-01-01

    In aerobiological studies it is often necessary to compare concentration data recorded with different models of sampling instrument. Sampler efficiency typically varies from device to device, and depends on the target aerosol and local atmospheric conditions. To account for these differences inter-sampler correction factors may be applied, however for many pollen samplers and pollen taxa such correction factors do not exist and cannot be derived from existing published work. In this study, the relative efficiencies of the Burkard 7-Day Recording Volumetric Spore Trap, the Sampling Technologies Rotorod Model 20, and the Burkard Personal Volumetric Air Sampler were evaluated for Urticaceae and Poaceae pollen under field conditions. The influence of wind speed and relative humidity on these efficiency relationships was also assessed. Data for the two pollen taxa were collected during 2010 and 2011-2012, respectively. The three devices were found to record significantly different concentrations for both pollen taxa, with the exception of the 7-Day and Rotorod samplers for Poaceae pollen. Under the range of conditions present during the study, wind speed was found to only have a significant impact on inter-sampler relationships involving the vertically-orientated Burkard Personal sampler, while no interaction between relative efficiency and relative humidity was observed. Data collected with the three models of sampler should only be compared once the appropriate correction has been made, with wind speed taken into account where appropriate.

  6. Nocturia and polyuria in men referred with lower urinary tract symptoms, assessed using a 7-day frequency-volume chart.

    PubMed

    Matthiesen, T B; Rittig, S; Mortensen, J T; Djurhuus, J C

    1999-06-01

    To investigate if a 7-day frequency-volume (FV) chart could identify nocturia on a polyuric basis in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). The study included 23 patients (mean age 62.8 years, range 42-78) with LUTS who were referred for the evaluation of potential BPH and 11 men (control subjects, mean age 63.3 years, range 58-69); all completed a 7-day FV chart investigation as outpatients. Nocturia was associated with nocturnal polyuria in 10 of 23 patients with LUTS; these 10 patients had a diminished diurnal variation of urine production, whereas 13 patients had a diurnal variation in urine production comparable with that in controls with no nocturia. The degree of nocturia correlated positively with nocturnal urine production but showed no relationship with sleep duration. The nocturnal polyuria in these patients was associated with a higher 24-h urine production and seemed at least partly to be caused by a higher fluid intake during daytime. Nocturia on a polyuric basis can be detected by using a FV chart. In these patients, a 3-day FV chart would be sufficient to detect nocturia on a polyuric basis and seems therefore to be a valuable tool in evaluating patients with LUTS referred for potential BPH.

  7. Growth Recovery of Lemna gibba and Lemna minor Following a 7-Day Exposure to the Herbicide Diuron.

    PubMed

    Burns, Mitchell; Hanson, Mark L; Prosser, Ryan S; Crossan, Angus N; Kennedy, Ivan R

    2015-08-01

    In agricultural catchments, aquatic ecosystems can experience a pulse exposure to pesticides. Following such exposure, non-target organisms that are not extirpated may recover. This paper investigates the potential of two duckweed species (Lemna minor and Lemna gibba) to recover from a 7-day exposure to different concentrations (0.4-208 µg L(-1)) of the herbicide diuron. There was significant inhibition in the growth and biomass after the initial 7-day exposure (e.g. frond number EC50=59.2 and 52.2 µg L(-1) for L. minor and L. gibba, respectively). Following transfer to clean media, recovery (the highest concentration yielding no significant difference in the effect endpoint from the control) was observed for all effects endpoints at concentrations ranging 60-111 µg L(-1) for L. minor and 60-208 µg L(-1) for L. gibba. These results suggest that recovery is possible for primary producers at environmentally relevant concentrations considered significant in ecological risk assessment.

  8. TRIPPING CIRCUIT

    DOEpatents

    Lees, G.W.; McCormick, E.D.

    1962-05-22

    A tripping circuit employing a magnetic amplifier for tripping a reactor in response to power level, period, or instrument failure is described. A reference winding and signal winding are wound in opposite directions on the core. Current from an ion chamber passes through both windings. If the current increases at too fast a rate, a shunt circuit bypasses one or the windings and the amplifier output reverses polarity. (AEC)

  9. CFD and ventilation research.

    PubMed

    Li, Y; Nielsen, P V

    2011-12-01

    There has been a rapid growth of scientific literature on the application of computational fluid dynamics (CFD) in the research of ventilation and indoor air science. With a 1000-10,000 times increase in computer hardware capability in the past 20 years, CFD has become an integral part of scientific research and engineering development of complex air distribution and ventilation systems in buildings. This review discusses the major and specific challenges of CFD in terms of turbulence modelling, numerical approximation, and boundary conditions relevant to building ventilation. We emphasize the growing need for CFD verification and validation, suggest ongoing needs for analytical and experimental methods to support the numerical solutions, and discuss the growing capacity of CFD in opening up new research areas. We suggest that CFD has not become a replacement for experiment and theoretical analysis in ventilation research, rather it has become an increasingly important partner. We believe that an effective scientific approach for ventilation studies is still to combine experiments, theory, and CFD. We argue that CFD verification and validation are becoming more crucial than ever as more complex ventilation problems are solved. It is anticipated that ventilation problems at the city scale will be tackled by CFD in the next 10 years. © 2011 John Wiley & Sons A/S.

  10. Adaptive lung ventilation.

    PubMed

    Linton, D M

    2001-09-01

    Adaptive lung ventilation (ALV) is a method of closed-loop mechanical ventilation analogous to modern closed-loop technology in aviation such as the autopilot and automatic landing system. The algorithm of the controller of ALV is designed to automatically provide pressure-controlled synchronized intermittent mandatory ventilation (P-SIMV) and weaning as individually required in any clinical situation. The synchronized pressure limited breaths constantly adapt to the patient requirements to encourage optimal alveolar ventilation with minimal adverse physiological disturbance and timely weaning. The ease of application, efficiency, and safety of the first ALV controllers have been demonstrated in lung models, in patients with normal lungs undergoing general anesthesia, in patients requiring unusual positioning, in transition to and from one-lung anesthesia, and in long-term ventilation of patients with various lung pathologies and in weaning patients who have restrictive or obstructive pulmonary disease. Prospective comparative studies of ALV versus other currently used manually selected modes of mechanical ventilation, such as the one reported in this article, should confirm the safety and identify the benefits of this form of advanced closed-loop mechanical ventilation technology.

  11. A 7-day continuous infusion of PTH or PTHrP suppresses bone formation and uncouples bone turnover.

    PubMed

    Horwitz, Mara J; Tedesco, Mary Beth; Sereika, Susan M; Prebehala, Linda; Gundberg, Caren M; Hollis, Bruce W; Bisello, Alessandro; Garcia-Ocaña, Adolfo; Carneiro, Raquel M; Stewart, Andrew F

    2011-09-01

    Human in vivo models of primary hyperparathyroidism (HPT), humoral hypercalcemia of malignancy (HHM), or lactational bone mobilization for more than 48 hours have not been described previously. We therefore developed 7-day continuous-infusion models using human parathyroid hormone(1-34) [hPTH(1-34)] and human parathyroid hormone-related protein(1-36) [hPTHrP(1-36)] in healthy human adult volunteers. Study subjects developed sustained mild increases in serum calcium (10.0 mg/dL), with marked suppression of endogenous PTH(1-84). The maximal tolerated infused doses over a 7-day period (2 and 4 pmol/kg/h for PTH and PTHrP, respectively) were far lower than in prior, briefer human studies (8 to 28 pmol/kg/h). In contrast to prior reports using higher PTH and PTHrP doses, both 1,25-dihydroxyvitamin D(3) [1,25(OH)(2) D(3) ] and tubular maximum for phosphorus (TmP/GFR) remained unaltered with these low doses despite achievement of hypercalcemia and hypercalciuria. As expected, bone resorption increased rapidly and reversed promptly with cessation of the infusion. However, in contrast to events in primary HPT, bone formation was suppressed by 30% to 40% for the 7 days of the infusions. With cessation of PTH and PTHrP infusion, bone-formation markers abruptly rebounded upward, confirming that bone formation is suppressed by continuous PTH or PTHrP infusion. These studies demonstrate that continuous exposure of the human skeleton to PTH or PTHrP in vivo recruits and activates the bone-resorption program but causes sustained arrest in the osteoblast maturation program. These events would most closely mimic and model events in HHM. Although not a perfect model for lactation, the increase in resorption and the rebound increase in formation with cessation of the infusions are reminiscent of the maternal skeletal calcium mobilization and reversal that occur following lactation. The findings also highlight similarities and differences between the model and HPT. Copyright

  12. Ventilating Air-Conditioner

    NASA Technical Reports Server (NTRS)

    Dinh, Khanh

    1994-01-01

    Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

  13. Ventilating Air-Conditioner

    NASA Technical Reports Server (NTRS)

    Dinh, Khanh

    1994-01-01

    Air-conditioner provides ventilation designed to be used alone or incorporated into cooling or heating system operates efficiently only by recirculating stale air within building. Energy needed to operate overall ventilating cooling or heating system slightly greater than operating nonventilating cooling or heating system. Helps to preserve energy efficiency while satisfying need for increased forced ventilation to prevent accumulation of undesired gases like radon and formaldehyde. Provides fresh treated air to variety of confined spaces: hospital surgeries, laboratories, clean rooms, and printing shops and other places where solvents used. In mobile homes and portable classrooms, eliminates irritant chemicals exuded by carpets, panels, and other materials, ensuring healthy indoor environment for occupants.

  14. Adherence to 7-Day Primaquine Treatment for the Radical Cure of P. vivax in the Peruvian Amazon

    PubMed Central

    Grietens, Koen Peeters; Soto, Veronica; Erhart, Annette; Ribera, Joan Muela; Toomer, Elizabeth; Tenorio, Alex; Montalvo, Tanilu Grande; Rodriguez, Hugo; Cuentas, Alejandro Llanos; D'Alessandro, Umberto; Gamboa, Dionicia

    2010-01-01

    Despite being free of charge, treatment adherence to 7-day primaquine for the radical cure of Plasmodium vivax was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon. The principal reason for non-adherence was the perceived adverse effects related to local humoral illness conceptions that hold that malaria produces a hot state of body, which is further aggravated by the characteristically hot medical treatment. Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills. Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence. Improving community awareness about the role of primaquine to prevent further malaria transmission and fostering a realistic system of direct observed treatment intake, organized at community level, can be expected to improve adherence to the radical cure of P. vivax in this area. PMID:20519594

  15. Impact of a 7-Day Field Training on Oral Health Condition in Japan Ground Self-Defense Force Personnel.

    PubMed

    Yamashita, Koji; Nishiyama, Takeshi; Nagata, Emi; Ramadhani, Atik; Kawada-Matsuo, Miki; Komatsuzawa, Hitoshi; Oho, Takahiko

    2017-07-01

    In the Japan Ground Self-Defense Force (JGSDF), personnel periodically perform intensive training that mimics the conditions seen in battle and during natural disasters. Military training involves intensive, stressful conditions, and changes in immune responses have been found in personnel following training. Good oral condition is important for military personnel to fulfill their duties; however, they have difficulty performing daily oral care under training conditions. In this study, we investigated the impact of a 7-day field training on the oral health status of JGSDF personnel by comparing their oral condition before and just after training. The participants were 59 male and 3 female JGSDF personnel undergoing a 7-day field training. All personnel provided informed written consent to participate, and this study was approved by the ethics committee of the Kagoshima University Graduate School of Medical and Dental Sciences. Oral health behaviors before and during the training period were surveyed using a self-administered questionnaire. Dental caries was assessed before training in terms of decayed, missing and filled teeth (DMFT), and periodontal condition was examined before and immediately after training using the community periodontal index (CPI). The presence of eight species of bacteria in dental plaque, including commensal streptococci that are early colonizers on the tooth surface, cariogenic bacteria, and periodontopathic bacteria, was determined using real-time polymerase chain reaction. We also assessed antibacterial factors and a stress marker in saliva samples. Sample collection was performed before and just after training. In addition to difference analysis between groups, logistic regression analysis was performed to examine the association between each health behavior and periodontal deterioration. The frequency of toothbrushing decreased, and snacking increased during the training period. Thirty-five personnel (56.5%) showed an increase in

  16. Gender differences in endocrine responses to posture and 7 days of -6 degrees head-down bed rest

    NASA Technical Reports Server (NTRS)

    Vernikos, J.; Dallman, M. F.; Keil, L. C.; O'Hara, D.; Convertino, V. A.

    1993-01-01

    Endocrine regulation of fluids and electrolytes during 7 days of -6 degrees head-down bed rest (HDBR) was compared in male (n = 8) and, for the first time, female (n = 8) volunteers. The subjects' responses to quiet standing for 2 h before and after HDBR were also tested. In both sexes, diuresis and natriuresis were evident during the first 2-3 days of HDBR, resulting in a marked increase in the urinary Na(+)-to-K+ ratio and significant Na+ retention on re-ambulation. After the 1st day of HDBR, plasma renin activity (PRA) was increased relative to aldosterone (Aldo), plasma volume was decreased, and the renal response to Aldo appeared to be appropriate. Circulating levels of arginine vasopressin, cortisol, and ACTH were unchanged during HDBR. Plasma testosterone decreased slightly on day 2 of HDBR in males. The ratio of early morning ACTH to cortisol was lower in females than in males because ACTH was lower in females. Urinary cortisol increased and remained elevated throughout the HDBR in males only. There were no gender differences in the responses to 7 days of HDBR, except those in the pituitary-adrenal system; those differences appeared unrelated to the postural change. The provocative cardiovascular test of quiet standing before and after HDBR revealed both sex differences and effects of HDBR. There were significant sex differences in cardiovascular responses to standing before and after HDBR. Females had greater PRA and Aldo responses to standing before HDBR and larger Aldo responses to standing after HDBR than males.(ABSTRACT TRUNCATED AT 250 WORDS).

  17. Gender differences in endocrine responses to posture and 7 days of -6 degrees head-down bed rest

    NASA Technical Reports Server (NTRS)

    Vernikos, J.; Dallman, M. F.; Keil, L. C.; O'Hara, D.; Convertino, V. A.

    1993-01-01

    Endocrine regulation of fluids and electrolytes during 7 days of -6 degrees head-down bed rest (HDBR) was compared in male (n = 8) and, for the first time, female (n = 8) volunteers. The subjects' responses to quiet standing for 2 h before and after HDBR were also tested. In both sexes, diuresis and natriuresis were evident during the first 2-3 days of HDBR, resulting in a marked increase in the urinary Na(+)-to-K+ ratio and significant Na+ retention on re-ambulation. After the 1st day of HDBR, plasma renin activity (PRA) was increased relative to aldosterone (Aldo), plasma volume was decreased, and the renal response to Aldo appeared to be appropriate. Circulating levels of arginine vasopressin, cortisol, and ACTH were unchanged during HDBR. Plasma testosterone decreased slightly on day 2 of HDBR in males. The ratio of early morning ACTH to cortisol was lower in females than in males because ACTH was lower in females. Urinary cortisol increased and remained elevated throughout the HDBR in males only. There were no gender differences in the responses to 7 days of HDBR, except those in the pituitary-adrenal system; those differences appeared unrelated to the postural change. The provocative cardiovascular test of quiet standing before and after HDBR revealed both sex differences and effects of HDBR. There were significant sex differences in cardiovascular responses to standing before and after HDBR. Females had greater PRA and Aldo responses to standing before HDBR and larger Aldo responses to standing after HDBR than males.(ABSTRACT TRUNCATED AT 250 WORDS).

  18. Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor

    PubMed Central

    Xu, Wenhua; Li, Mingfang; Chen, Minglong; Yang, Bing; Wang, Daowu; Kong, Xiangqing; Chen, Hongwu; Ju, Weizhu; Gu, Kai; Cao, Kejiang; Liu, Hailei; Jiang, Qi; Shi, Jiaojiao; Cui, Yan; Wang, Hong

    2015-01-01

    Abstract Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P<0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P<0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction. PMID:26668581

  19. Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor.

    PubMed

    Xu, Wenhua; Li, Mingfang; Chen, Minglong; Yang, Bing; Wang, Daowu; Kong, Xiangqing; Chen, Hongwu; Ju, Weizhu; Gu, Kai; Cao, Kejiang; Liu, Hailei; Jiang, Qi; Shi, Jiaojiao; Cui, Yan; Wang, Hong

    2015-11-01

    Recent studies have shown that premature ventricular contractions (PVCs) could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular (LV) function in patients with PVCs by 7-day Holter electrocardiography (ECG). From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors' affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction (EF) level and a lower LV end-systolic dimension (ESD) than other PVC foci (P<0.05). The high burden group had a higher LV end-diastolic dimension (EDD) and LVESD but lower LVEF than the other two groups (P<0.05). Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.

  20. Targeting circuits

    PubMed Central

    Rajasethupathy, Priyamvada; Ferenczi, Emily; Deisseroth, Karl

    2017-01-01

    Current optogenetic methodology enables precise inhibition or excitation of neural circuits, spanning timescales as needed from the acute (milliseconds) to the chronic (many days or more), for experimental modulation of network activity and animal behavior. Such broad temporal versatility, unique to optogenetic control, is particularly powerful when combined with brain activity measurements that span both acute and chronic timescales as well. This enables, for instance, the study of adaptive circuit dynamics across the intact brain, and tuning interventions to match activity patterns naturally observed during behavior in the same individual. Although the impact of this approach has been greater on basic research than on clinical translation, it is natural to ask if specific neural circuit activity patterns discovered to be involved in controlling adaptive or maladaptive behaviors could become targets for treatment of neuropsychiatric diseases. Here we consider the landscape of such ideas related to therapeutic targeting of circuit dynamics, taking note of developments not only in optical but also in ultrasonic, magnetic, and thermal methods. We note the recent emergence of first-in-kind optogenetically-guided clinical outcomes, as well as opportunities related to the integration of interventions and readouts spanning diverse circuit-physiology, molecular, and behavioral modalities. PMID:27104976

  1. Why We Ventilate

    SciTech Connect

    Logue, Jennifer M.; Sherman, Max H.; Price, Phil N.; Singer, Brett C.

    2011-09-01

    It is widely accepted that ventilation is critical for providing good indoor air quality (IAQ) in homes. However, the definition of"good" IAQ, and the most effective, energy efficient methods for delivering it are still matters of research and debate. This paper presents the results of work done at the Lawrence Berkeley National Lab to identify the air pollutants that drive the need for ventilation as part of a larger effort to develop a health-based ventilation standard. First, we present results of a hazard analysis that identified the pollutants that most commonly reach concentrations in homes that exceed health-based standards or guidelines for chronic or acute exposures. Second, we present results of an impact assessment that identified the air pollutants that cause the most harm to the U.S. population from chronic inhalation in residences. Lastly, we describe the implications of our findings for developing effective ventilation standards.

  2. Outcome of mechanically ventilated patients who require a tracheostomy.

    PubMed

    Frutos-Vivar, Fernando; Esteban, Andrés; Apezteguía, Carlos; Anzueto, Antonio; Nightingale, Peter; González, Marco; Soto, Luis; Rodrigo, Carlos; Raad, Jean; David, Cide M; Matamis, Dimitros; D' Empaire, Gabriel

    2005-02-01

    To estimate the prevalence of, the risk factors associated with, and the outcome of tracheostomy in a heterogeneous population of mechanically ventilated patients. Prospective, observational cohort study. A total of 361 intensive care units from 12 countries. A cohort of 5,081 patients mechanically ventilated for >12 hrs. None. A total of 546 patients (10.7%) had a tracheostomy during their stay in the intensive care unit. Tracheostomy was performed at a median time of 12 days (interquartile range, 7-17) from the beginning of mechanical ventilation. Variables associated with the performance of tracheostomy were duration of mechanical ventilation, need for reintubation, and neurologic disease as the primary reason of mechanical ventilation. The intensive care unit stay of patients with or without tracheostomy was a median of 21 days (interquartile range, 12-32) vs. 7 days (interquartile range, 4-12; p < .001), respectively, and the hospital stay was a median 36 days (interquartile range, 23-53) vs. 15 days (interquartile range, 8-26; p < .001), respectively. Adjusting by other variables, tracheostomy was independently related with survival in the intensive care unit (odds ratio, 2.22; 95% confidence interval, 1.72-2.86). Mortality in the hospital was similar in both groups (39% vs. 40%, p = .65). Tracheostomy is a common surgical procedure in the intensive care unit that is associated with a lower mortality in the unit but with a longer stay and a similar mortality in the hospital than in patients without tracheostomy.

  3. Conventional mechanical ventilation

    PubMed Central

    Tobias, Joseph D.

    2010-01-01

    The provision of mechanical ventilation for the support of infants and children with respiratory failure or insufficiency is one of the most common techniques that are performed in the Pediatric Intensive Care Unit (PICU). Despite its widespread application in the PICUs of the 21st century, before the 1930s, respiratory failure was uniformly fatal due to the lack of equipment and techniques for airway management and ventilatory support. The operating rooms of the 1950s and 1960s provided the arena for the development of the manual skills and the refinement of the equipment needed for airway management, which subsequently led to the more widespread use of endotracheal intubation thereby ushering in the era of positive pressure ventilation. Although there seems to be an ever increasing complexity in the techniques of mechanical ventilation, its successful use in the PICU should be guided by the basic principles of gas exchange and the physiology of respiratory function. With an understanding of these key concepts and the use of basic concepts of mechanical ventilation, this technique can be successfully applied in both the PICU and the operating room. This article reviews the basic physiology of gas exchange, principles of pulmonary physiology, and the concepts of mechanical ventilation to provide an overview of the knowledge required for the provision of conventional mechanical ventilation in various clinical arenas. PMID:20927268

  4. Noninvasive ventilation: practical advice.

    PubMed

    Bello, Giuseppe; De Pascale, Gennaro; Antonelli, Massimo

    2013-02-01

    This critical review discusses the key points that would be of practical help for the clinician who applies noninvasive ventilation (NIV) for treatment of patients with acute respiratory failure (ARF). In recent years, the growing role of NIV in the acute care setting has led to the development of technical innovations to overcome the problems related to gas leakage and dead space. A considerable amount of research has been conducted to improve the quality of the devices as well as optimize ventilation modes used to administer NIV. As a result, also mechanical ventilators have been implemented with modalities aimed at delivering NIV. The success of NIV in patients with ARF depends on several factors, including the skills of the clinician, selection of patient, choice of interface, selection of ventilation mode and ventilator setting, monitoring, and the motivation of the patient. Recent advances in the understanding of the physiological aspects of using NIV through different interfaces and ventilator settings have led to improve patient-machine interaction, enhancing favorable NIV outcome.

  5. Trigger Circuit.

    DTIC Science & Technology

    A wire of Nitinol can be stretched up to a given amount and will remain in this stretched state until heated to a critical temperature. When heated...circuit of this invention provides a current pulse for the required time period to heat the Nitinol wire to its critical temperature to thereby restore the...wire to its original length. The circuit includes a high power transistor which is gated on for a controlled time to provide the required power to heat the Nitinol wire to its critical temperature. (Author)

  6. MULTIPLIER CIRCUIT

    DOEpatents

    Chase, R.L.

    1963-05-01

    An electronic fast multiplier circuit utilizing a transistor controlled voltage divider network is presented. The multiplier includes a stepped potentiometer in which solid state or transistor switches are substituted for mechanical wipers in order to obtain electronic switching that is extremely fast as compared to the usual servo-driven mechanical wipers. While this multiplier circuit operates as an approximation and in steps to obtain a voltage that is the product of two input voltages, any desired degree of accuracy can be obtained with the proper number of increments and adjustment of parameters. (AEC)

  7. Efficacy and Safety of Single and Double Doses of Ivermectin versus 7-Day High Dose Albendazole for Chronic Strongyloidiasis

    PubMed Central

    Suputtamongkol, Yupin; Premasathian, Nalinee; Bhumimuang, Kid; Waywa, Duangdao; Nilganuwong, Surasak; Karuphong, Ekkapun; Anekthananon, Thanomsak; Wanachiwanawin, Darawan; Silpasakorn, Saowaluk

    2011-01-01

    Background Strongyloidiasis, caused by an intestinal helminth Strongyloides stercoralis, is common throughout the tropics. It remains an important health problem due to autoinfection, which may result in hyperinfection and disseminated infection in immunosuppressed patients, especially patients receiving chemotherapy or corticosteroid treatment. Ivermectin and albendazole are effective against strongyloidiasis. However, the efficacy and the most effective dosing regimen are to be determined. Methods A prospective, randomized, open study was conducted in which a 7-day course of oral albendazole 800 mg daily was compared with a single dose (200 microgram/kilogram body weight), or double doses, given 2 weeks apart, of ivermectin in Thai patients with chronic strongyloidiasis. Patients were followed-up with 2 weeks after initiation of treatment, then 1 month, 3 months, 6 months, 9 months, and 1 year after treatment. Combination of direct microscopic examination of fecal smear, formol-ether concentration method, and modified Koga agar plate culture were used to detect strongyloides larvae in two consecutive fecal samples in each follow-up visit. The primary endpoint was clearance of strongyloides larvae from feces after treatment and at one year follow-up. Results Ninety patients were included in the analysis (30, 31 and 29 patients in albendazole, single dose, and double doses ivermectin group, respectively). All except one patient in this study had at least one concomitant disease. Diabetes mellitus, systemic lupus erythrematosus, nephrotic syndrome, hematologic malignancy, solid tumor and human immunodeficiency virus infection were common concomitant diseases in these patients. The median (range) duration of follow-up were 19 (2–76) weeks in albendazole group, 39 (2–74) weeks in single dose ivermectin group, and 26 (2–74) weeks in double doses ivermectin group. Parasitological cure rate were 63.3%, 96.8% and 93.1% in albendazole, single dose oral ivermectin

  8. 14 CFR 25.831 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Ventilation and Heating § 25.831 Ventilation... probable failures or malfunctioning of the ventilating, heating, pressurization, or other systems...

  9. 14 CFR 25.831 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Ventilation and Heating § 25.831 Ventilation... probable failures or malfunctioning of the ventilating, heating, pressurization, or other systems...

  10. 14 CFR 25.831 - Ventilation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Ventilation and Heating § 25.831 Ventilation... probable failures or malfunctioning of the ventilating, heating, pressurization, or other systems...

  11. 14 CFR 25.831 - Ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Ventilation and Heating § 25.831 Ventilation... probable failures or malfunctioning of the ventilating, heating, pressurization, or other systems...

  12. Ofloxacin pharmacokinetics in mechanically ventilated patients.

    PubMed Central

    Martin, C; Lambert, D; Bruguerolle, B; Saux, P; Freney, J; Fleurette, J; Meugnier, H; Gouin, F

    1991-01-01

    The pharmacokinetics of ofloxacin were studied in 12 intensive care patients, 6 of whom were under controlled mechanical ventilation. All patients had a creatinine clearance of greater than 80 ml/min per 1.73 m2. They were given 3 mg of ofloxacin per kg of body weight intravenously at a constant flow rate in 30 min twice a day for 7 days. Pharmacokinetic studies were performed on days 1 and 7. Between days 1 and 7, significant increases in the alpha (distribution) and beta (elimination) phase half-lives, the area under the serum concentration-time curve, and peak and trough levels in serum were observed, together with a marked decrease (greater than 50%) in total body clearance. Possible contributing factors for alteration of ofloxacin pharmacokinetics in ventilated patients were patient age, liver dysfunction, drug interaction, and drug accumulation in a deep compartment. This study shows that in intensive care patients the pharmacokinetics of ofloxacin differ from those reported for healthy volunteers. PMID:1929329

  13. UNTREATED TRANSIENT LONGER THAN 7-DAY CHAT, CIRCADIAN HYPER-AMPLITUDE TENSION, IN A 7-YEAR PERSPECTIVE

    PubMed Central

    SCHWARTZKOPFF, O.; CORNÉLISSEN, G.; HALPIN, C.; KATINAS, G.; SIEGELOVÁ, J.; FIŠER, B.; DUŠEK, J.; HALBERG, F.

    2008-01-01

    The case report presented herein aims at promoting the awareness in medical, notably cardiological, practice of the importance of, first, collecting at least a week-long record of around-the-clock measurements of blood pressure (BP) and heart rate (HR) (and a much longer record if the 7 day record so indicates) and, second, of analysing the data chronobiologically in the light of reference values specified as a function of time, gender and age as a minimum. In addition to diagnosing deviations in a chronome (time structure)-adjusted mean value, a chronobiological approach identifies abnormalities in the variability of BP and/or HR, gauged by the circadian characteristics (double amplitude and acrophase, measures of the extent and timing of predictable change within a cycle) and by the standard deviation. A woman in presumably good health was 60 years of age at the start of intermittent monitoring over a 7 year span. The case report illustrates the extent to which a decision based on single BP readings and even on 24 hour averages may be misleading. Treatment based on an initial week-long monitoring may benefit from continued long-term monitoring. PMID:19018290

  14. Toxicity evaluation of waters from a tributary of the River Po using the 7-Day Ceriodaphnia dubia test.

    PubMed

    Viganò, L; Bassi, A; Garino, A

    1996-12-01

    Seven-day toxicity tests with Ceriodaphnia dubia were used to assess ambient water toxicity in the River Lambro, a tributary of the River Po, and in the corresponding stretch of the main river located downstream from their confluence. About once a month, toxicity tests were conducted on water samples of the River Lambro, using as dilution water the water of the main river collected upstream from the confluence. With a lower frequency, the downstream stretch of the River Po was tested for ambient toxicity at four sites located at 6, 11, 16, and 21 km from the emission of the tributary. The River Lambro demonstrated variable toxicity in different time periods, although the most frequent effects were sublethal, on both reproduction and growth. Ammonia, nickel, and zinc can be indicated as possible toxicants. Acute toxic effects to C. dubia were observed with spring samples only, when the action of some pesticides, likely insecticides, have to be taken into account. Tests conducted on downstream water gave limited results, seemingly because the dilution capacity of the River Po reduced Lambro toxicity to a level close to and often below the detection limit of the 7-day test. Accordingly, toxic effects at downstream sites could only be observed on the growth of C. dubia, which was found to be the most sensitive endpoint. Fairly good agreement was found between predictions based on toxicity tests of the River Lambro and the effects observed for downstream samples.

  15. Growth, reproduction and population growth of Ceriodaphnia cornuta sars and comparison of 7-day fecundity with Ceriodaphnia dubia richard

    NASA Astrophysics Data System (ADS)

    Zhuang, Dehui

    1989-06-01

    Biology of parthenogenetic females of Ceriodaphnia cornuta Sars was studied under laboratory conditions. The mean length of neonates (first-young instars) of Ceriodaphnia cornuta was found to be 0.27 mm at 25±1°C and that of the first adult instars 0.50 mm. A maximum length of 0.69 mm was attained at the 8th adult instar. The mean longevity was found to be 19.0 days for 3 preadult and 8 adult instars. Sex maturity was reached in 4.26 days. The mean number of young per brood was 6.21. The total production for each adult reached 49.7. The maximum reproduction period occurred during the 4th adult instar. At this age, the animals were 10.25 days old, and had a body length of 0.65 mm. The innate capacity for increase ( r m) was 0.40 per female per day, the net reproduction rate ( R 0) was 33.601 per generation, the mean length of a generation ( T) was 8.786 days, and the finite rate for increase (λ) was 1.492 per female per day. Comparisons using the t-test indicated that the number of eggs produced and number of broods of C. cornuta and C. dubia were not significantly different ( p>0.05) after 7 days.

  16. [The fructose induced "glycogenosis". I. Ultrastructural and morphometric analysis of rat hepatocytes 7 days after fructose overload (author's transl)].

    PubMed

    Riede, U N; Uhl, H; Seufer, G; Robausch, T; Böhm, N; Sasse, D

    1975-01-01

    Infusion of fructose has been shown to stimulate the SER and to reduce the RER in rat liver cells. After feeding fructose of 7 days a glycogenosis of unknown pathogenesis occurs, which was analysed morphometrically. 60% fructose in water, was given as drinking water to animals deprived of other food. Controls had free access to Altromin-R-standard diet and drinking water. Liver tissue was analysed morphometrically according to the methods described by Weibel. Rat hepatocytes accumulate a material with histochemical properties of glycogen. The enlargement of hepatic nuclei is probably due to a pathological edema. The SER is decreased suggesting a drop of glycogen catabolizing enzymes. The drastic reduction of the RER and the non-membrane bound ribosomes are signs of inpeeded protein synthesis. According to this, the peroxisomes, which arise from the RER, are decreased in volume and number. The hepatocellular chondrioma is transformed morphometrically in a smaller number of larger, pleomorphic and cup-shaped mitochondria. The ATP level drops while, on the other hand, the cristeal membranes increase. This might be caused by a negative feed back mechanism. The hepatocellular cytoarchitecture described is similar to the one found in glycogenosis type I and in the cerebrohepato-renal syndrom.

  17. The effects of modafinil treatment on neuropsychological and attentional bias performance during 7-day inpatient withdrawal from methamphetamine dependence.

    PubMed

    Hester, Robert; Lee, Nicole; Pennay, Amy; Nielsen, Suzi; Ferris, Jason

    2010-12-01

    The cognitive benefits of modafinil to patients undergoing 7-day inpatient withdrawal from methamphetamine (MA) dependence were examined as part of a double-blind, randomized, placebo-controlled pilot trial. Recent evidence has identified modafinil-related improvements in treatment outcomes for MA-dependent patients; however, the benefits to cognition function, which is critical to treatment success but known to be impaired, has yet to be examined. The first 20 participants recruited to the study were administered either 200 mg of modafinil (once daily) or placebo, and a neuropsychological test battery (including an MA version of the emotional Stroop task) at admission (n = 17) and discharge (n = 14). Follow-up interviews were conducted at 1-month postdischarge (n = 13). After participant withdrawals (3 in each group), treatment was associated with a significant improvement in immediate verbal memory recall and nonsignificant trend toward improvement on executive function and delayed memory tasks. No benefit was seen for measures of verbal learning, visual memory, processing speed, or verbal fluency. All participants showed a significant attentional bias for MA-related stimuli on the emotional Stroop task. The magnitude of bias predicted both retention in treatment and relapse potential at follow-up but was not significantly ameliorated by modafinil treatment. While nonsignificant, the effect sizes of modafinil-related improvements in executive function and memory were consistent with those found in more robustly powered studies of cognitive benefits in attention-deficit/hyperactivity disorder and schizophrenia, supporting the need for further research.

  18. Weaning from artificial ventilation.

    PubMed

    Mancebo, J

    1998-06-01

    Every intubated and mechanically-ventilated patient should be clinically evaluated, at least on a daily basis, by a skilled team in order to speed up the weaning process as much as possible. Again, it should be emphasized that the adoption of an active clinical strategy when faced with "difficult" to wean patients is of paramount importance. In one study, performed in Spain, analysing the prevalence of mechanical ventilation in intensive care units [3], reported the mean number of days that patients spent on mechanical ventilation was 27. In a more recent intervention study, in which a specific protocol was followed each day [2], the mean number of days on mechanical ventilation was only 12. These data have been confirmed by several authors [4, 40], and it has also been reported that a protocol-directed weaning strategy leads not only to a significant reduction in the duration of mechanical ventilation but also to a significant decrease in the number of complications and cost [4]. However, even following a protocol-directed weaning strategy, it is possible that weaning duration can be further reduced. In a prospective study performed in our institution [41] during 32 months, we reported that, following an episode of unplanned extubation, the only independent variables associated with the need for reintubation were the number of days of mechanical ventilation and the type of ventilatory support at the time of autoextubation. Indeed, when patients were in the weaning period only 16% (5 out of 32) needed reintubation, whereas reintubation was needed in 82% (22 out of 27) of patients who had an unplanned extubation during full mechanical ventilatory support. These data suggest that there are still some patients being on mechanical ventilation for a longer than necessary period of time. Finally, very recent advances in technological areas such as artificial intelligence, are proving to be useful in the management of the weaning process. When such systems are applied to

  19. Performance characteristics of five new anesthesia ventilators and four intensive care ventilators in pressure-support mode: a comparative bench study.

    PubMed

    Jaber, Samir; Tassaux, Didier; Sebbane, Mustapha; Pouzeratte, Yvan; Battisti, Anne; Capdevila, Xavier; Eledjam, Jean-Jacques; Jolliet, Philippe

    2006-11-01

    During the past few years, many manufacturers have introduced new modes of ventilation in anesthesia ventilators, especially partial-pressure modalities. The current bench test study was designed to compare triggering and pressurization of five new anesthesia ventilators with four intensive care unit ventilators. Ventilators were connected to a two-compartment lung model. One compartment was driven by an intensive care unit ventilator to mimic "patient" inspiratory effort, whereas the other was connected to the tested ventilator. The settings of ventilators were positive end-expiratory pressures of 0 and 5 cm H2O, and pressure-support ventilation levels of 10, 15, and 20 cm H2O with normal and high "patient" inspiratory effort. For the anesthesia ventilators, all the measurements were obtained for a low (1 l/min) and a high (10 l/min) fresh gas flow. Triggering delay, triggering workload, and pressurization at 300 and 500 ms were analyzed. For the five tested anesthesia ventilators, the pressure-support ventilation modality functioned correctly. For inspiratory triggering, the three most recent anesthesia machines (Fabius, Drägerwerk AG, Lübeck, Germany; Primus, Drägerwerk AG; and Avance, GE-Datex-Ohemda, Munchen, Germany) had a triggering delay of less than 100 ms, which is considered clinically satisfactory and is comparable to intensive care unit machines. The use of positive end-expiratory pressure modified the quality of delivered pressure support for two anesthesia ventilators (Kion, Siemens AG, Munich, Germany; and Felix, Taema, Antony, France). Three of the five anesthesia ventilators exhibited pressure-support ventilation performance characteristics comparable to those of the intensive care unit machines. Increasing fresh gas flow (1 to 10 l/min) in the internal circuit did not influence the pressure-support ventilation performance of the anesthesia ventilators. Regarding trigger sensitivity and the system's ability to meet inspiratory flow during

  20. Subject-ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation.

    PubMed

    Moerer, Onnen; Beck, Jennifer; Brander, Lukas; Costa, Roberta; Quintel, Michael; Slutsky, Arthur S; Brunet, Fabrice; Sinderby, Christer

    2008-09-01

    Patient-ventilator synchrony during non-invasive pressure support ventilation with the helmet device is often compromised when conventional pneumatic triggering and cycling-off were used. A possible solution to this shortcoming is to replace the pneumatic triggering with neural triggering and cycling-off-using the diaphragm electrical activity (EA(di)). This signal is insensitive to leaks and to the compliance of the ventilator circuit. Randomized, single-blinded, experimental study. University Hospital. PARTICIPANTS AND SUBJECTS: Seven healthy human volunteers. Pneumatic triggering and cycling-off were compared to neural triggering and cycling-off during NIV delivered with the helmet. Triggering and cycling-off delays, wasted efforts, and breathing comfort were determined during restricted breathing efforts (<20% of voluntary maximum EA(di)) with various combinations of pressure support (PSV) (5, 10, 20 cm H(2)O) and respiratory rates (10, 20, 30 breath/min). During pneumatic triggering and cycling-off, the subject-ventilator synchrony was progressively more impaired with increasing respiratory rate and levels of PSV (p < 0.001). During neural triggering and cycling-off, effect of increasing respiratory rate and levels of PSV on subject-ventilator synchrony was minimal. Breathing comfort was higher during neural triggering than during pneumatic triggering (p < 0.001). The present study demonstrates in healthy subjects that subject-ventilator synchrony, trigger effort, and breathing comfort with a helmet interface are considerably less impaired during increasing levels of PSV and respiratory rates with neural triggering and cycling-off, compared to conventional pneumatic triggering and cycling-off.

  1. Alveolar recruitment of atelectasis under combined high-frequency jet ventilation: a computed tomography study.

    PubMed

    Kraincuk, Paul; Körmöczi, Günther; Prokop, Mathias; Ihra, Gerald; Aloy, Alexander

    2003-08-01

    To quantify the effect of superimposed high-frequency jet ventilation on lung recruitment in adult patients with acute lung injury. Prospective clinical study in the intensive care unit of a university teaching hospital. Eight adults suffering from acute lung injury with a mean lung injury score of 2.6+/-0.6 and pronounced atelectasis in at least two lung quadrants. The cause was either pneumonia ( n=5) or postoperative sepsis ( n=3). Superimposed high-frequency jet ventilation was initiated in patients following a mean of 4.4+/-1.7 days of conventional ventilation. Before and 4 h after the start of superimposed high-frequency jet ventilation differential lung volumes were determined by volumetry using computed tomography. Superimposed high-frequency jet ventilation significantly increased the lung volume of every patient due to alveolar recruitment. This was achieved despite lower peak inspiratory pressures and higher PaO(2)/FIO(2) ratios than with conventional ventilation. Treatment with superimposed high-frequency jet ventilation for 4 h resulted in rapid alveolar recruitment in dependent lung areas, improved gas exchange, and better arterial oxygenation. It offers an effective and advantageous alternative to conventional ventilation for ventilatory management of respiratory insufficient patients.

  2. TIMING CIRCUIT

    DOEpatents

    Heyd, J.W.

    1959-07-14

    An electronic circuit is described for precisely controlling the power delivered to a load from an a-c source, and is particularly useful as a welder timer. The power is delivered in uniform pulses, produced by a thyratron, the number of pulses being controlled by a one-shot multivibrator. The starting pulse is synchronized with the a-c line frequency so that each multivlbrator cycle begins at about the same point in the a-c cycle.

  3. Ventilation technologies scoping study

    SciTech Connect

    Walker, Iain S.; Sherman, Max H.

    2003-09-30

    This document presents the findings of a scoping study commissioned by the Public Interest Energy Research (PIER) program of the California Energy Commission to determine what research is necessary to develop new residential ventilation requirements for California. This study is one of three companion efforts needed to complete the job of determining the needs of California, determining residential ventilation requirements, and determining appropriate ventilation technologies to meet these needs and requirements in an energy efficient manner. Rather than providing research results, this scoping study identifies important research questions along with the level of effort necessary to address these questions and the costs, risks, and benefits of pursuing alternative research questions. In approaching these questions and level of effort, feasibility and timing were important considerations. The Commission has specified Summer 2005 as the latest date for completing this research in time to update the 2008 version of California's Energy Code (Title 24).

  4. Thermionic integrated circuits

    SciTech Connect

    MacRoberts, M.; Brown, D.R.; Dooley, R.; Lemons, R.; Lynn, D.; McCormick, B.; Mombourquette, C.; Sinah, D.

    1986-01-01

    Thermionic integrated circuits combine vacuum-tube technology with integrated-circuit techniques to form integrated vacuum circuits. These circuits are capable of extended operation in both high-temperature and high-radiation environments.

  5. Ventilation flow: Submerged

    NASA Technical Reports Server (NTRS)

    Hutchinson, D.

    1985-01-01

    The ventilation system on a submarine is discussed. When the submarine is submerged. The ventilation system provides a conditioned atmosphere in the ship with complete isolation from the outside. A conditioned atmosphere includes not only filtration and temperature and humidity control, but also air purification (removal of potentially harmful quantities of impurities and comtaminants) and revitalization (addition of vital life support oxygen). Carbon dioxide removal, the oxygen system, air conditioning, carbon monoxide removal, hydrogen removal, and atmosphere monitoring systems are among the topics discussed.

  6. Bench performance of ventilators during simulated paediatric ventilation.

    PubMed

    Park, M A J; Freebairn, R C; Gomersall, C D

    2013-05-01

    This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

  7. Meeting Residential Ventilation Standards Through Dynamic Control of Ventilation Systems

    SciTech Connect

    Sherman, Max H.; Walker, Iain S.

    2011-04-01

    Existing ventilation standards, including American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) Standard 62.2, specify continuous operation of a defined mechanical ventilation system to provide minimum ventilation, with time-based intermittent operation as an option. This requirement ignores several factors and concerns including: other equipment such as household exhaust fans that might incidentally provide ventilation, negative impacts of ventilation when outdoor pollutant levels are high, the importance of minimizing energy use particularly during times of peak electricity demand, and how the energy used to condition air as part of ventilation system operation changes with outdoor conditions. Dynamic control of ventilation systems can provide ventilation equivalent to or better than what is required by standards while minimizing energy costs and can also add value by shifting load during peak times and reducing intake of outdoor air contaminants. This article describes the logic that enables dynamic control of whole-house ventilation systems to meet the intent of ventilation standards and demonstrates the dynamic ventilation system control concept through simulations and field tests of the Residential Integrated Ventilation-Energy Controller (RIVEC).

  8. Gender differences in endocrine responses to posture and 7 days of 6 deg head down bed rest

    NASA Technical Reports Server (NTRS)

    Vernikos, J.; Dallman, M. F.; Keil, L. C.; Ohara, D.; Convertino, V. A.

    1993-01-01

    Endocrine regulation of fluids and electrolytes during seven days of 6 deg head down bed rest (HDBR) was compared in male (n = 8) and, for the first time, female (n = 8) volunteers. The subjects' responses to quiet standing for 2 hr before and after HDBR were also tested. In both sexes, diuresis and natriuresis were evident during the first 2-3 days of HDBR, resulting in a marked increase in the urinary Na/K ratio and significant Na retention on reambulation. After the first day of HDBR, plasma renin activity (PRA) was increased relative to aldosterone, plasma volume was decreased, and the renal response to aldosterone appeared to be appropriate. Circulating levels of arginine vasopressin (AVP), cortisol, and ACTH were unchanged during HDBR. Plasma testosterone decreased slightly on day 2 of HDBR in males. The ratio of AM ACTH to cortisol was lower in females than in males because ACTH was lower in females. Urinary cortisol increased and remained elevated throughout the HDBR in males only. There were no gender differences in the responses to 7 day HDBR, except those in the pituitary-adrenal system; those differences appeared unrelated to the postural change. The provocative cardiovascular test of quiet standing before and after bed rest revealed both sex differences and effects of HDBR. There were significant sex differences in cardiovascular responses to standing, before and after HDBR. Females had greater PRA and aldosterone responses to standing before bedrest and larger aldosterone responses to standing after HDBR than males. Cardiovascular responses to standing before and after bedrest differed markedly: arterial pressure and heart rates increased with standing before HDBR, by contrast, arterial pressure decreased, with greater increases in heart rates after HDBR. In both sexes, all hormonal responses to standing were greater after HDBR. The results show clearly that similar responses to standing as well as to HDBR occur in both sexes, but that females exhibit

  9. Planktonic and biofilm communities from 7-day-old chicken cecal microflora cultures: characterization and resistance to Salmonella colonization.

    PubMed

    Sheffield, C L; Crippen, T L; Andrews, K; Bongaerts, R J; Nisbet, D J

    2009-09-01

    Information implicating bacterial biofilms as contributory factors in the development of environmental bacterial resistance has been increasing. There is a lack of information regarding the role of biofilms within the microbial ecology of the gastrointestinal tract of food animals. This work used a continuous-flow chemostat model derived from the ceca of 7-day-old chicks to characterize these communities and their ability to neutralize invasion by Salmonella enterica serovar Typhimurium. We characterized and compared the biofilm and planktonic communities within these microcosms using automated ribotyping and the Analytical Profile Index biotyping system. Eleven species from eight different genera were identified from six culture systems. Klebsiella pneumoniae was isolated from all planktonic communities and four of the biofilm communities. Three of the communities resisted colonization by Salmonella enterica serovar Typhimurium, two communities suppressed growth, and one community succumbed to colonization. In cultures that resisted colonization, no Salmonella could be isolated from the biofilm; in cultures that succumbed to colonization, Salmonella was consistently found within the biofilms. This study was one of a series that provided a molecular-based characterization of both the biofilm and planktonic communities from continuous-flow culture systems derived from the cecal microflora of chicks, ranging in age from day-of-hatch to 14 days old. The one common factor relating to successful colonization of the culture was the presence of Salmonella within the biofilm. The capacity to sequester the introduced Salmonella into the biofilm appears to be a contributing factor to the inability of these cultures to withstand colonization by the Salmonella.

  10. Similar rebleeding rate in 3-day and 7-day intravenous ceftriaxone prophylaxis for patients with acute variceal bleeding.

    PubMed

    Lee, Tzong-Hsi; Huang, Chung-Tsui; Lin, Chien-Chu; Chung, Chen-Shuan; Lin, Cheng-Kuan; Tsai, Kuang-Chau

    2016-07-01

    Although prophylactic antibiotics have been recommended for cirrhotic patients with upper gastrointestinal bleeding, the duration of its use remains an inconclusive issue. We designed this study to investigate the duration of antibiotic prophylaxis for cirrhotic patients with acute esophageal variceal bleeding. We enrolled those patients suffering from acute esophageal variceal bleeding and receiving band ligation. They were randomly allocated to two groups to receive prophylactic antibiotics; Group I: receiving intravenous ceftriaxone 500 mg every 12 hours for 3 days, and Group II: same regimen for 7 days. We used rebleeding rate within 14 days as the primary end point and also evaluated the survival rate within 28 days and the amount of transfusion during admission. There were 38 patients in Group I and 33 patients in Group II that completed the study course for analysis. Overall, there was no significant difference in the baseline characteristics between these two groups. There were three patients both in Group I and Group II who developed rebleeding within 14 days (8% vs. 9%, p > 0.99). There was also no difference between Group I and Group II in transfusion amount (2.71 ± 2.84 units vs. 3.18 ± 4.07, p = 0.839) and survival rate in 28 days (100 vs. 97%, p = 0.465). Our small scale study demonstrated that there was no difference in the rebleeding rate between 3-day and 7-day ceftriaxone prophylaxis for cirrhotic patients with acute esophageal variceal bleeding. There was also no difference in 28 day survival rate between these two groups. Copyright © 2016. Published by Elsevier B.V.

  11. Impact of intracranial blood-flow redistribution on stroke size during ischemia-reperfusion in 7-day-old rats.

    PubMed

    Bonnin, Philippe; Leger, Pierre-Louis; Deroide, Nicolas; Fau, Sébastien; Baud, Olivier; Pocard, Marc; Charriaut-Marlangue, Christiane; Renolleau, Sylvain

    2011-05-15

    We evaluated color-coded pulsed Doppler ultrasound imaging for the assessment of intracranial blood flow in two models of cerebral ischemia in 7-day-old (P7) rats. Blood-flow velocities (BFVs) were measured in the internal carotid arteries and basilar trunk upstream from the circle of Willis, and in the posterior cerebral arteries downstream (1) before, (2) during left middle cerebral artery electrocoagulation and 50 min-transient either one (I/R-1) or both (I/R-2) common carotid (CCA) arteries occlusion, and (3) after release of CCA(s) occlusion. At 48 h after ischemia 41-48% (I/R-1 model) and 24% (I/R-2 model) of rats did not present a lesion. Those rats displayed increased mean BFV in both right internal carotid artery and basilar trunk in I/R-1 model, and increased mean BFV in the basilar trunk (BT) in I/R-2 model. In contrast, no significant changes in mean BFV were observed in lesioned rats. Furthermore, mean BFV in the BT was inversely correlated to the size of the lesion (r² = 0.75, p<0.0001) in the I/R-2 model. Thus, we demonstrated the protective role of collateral support in P7 rodents. Ultrasound imaging can evidence the establishment or not of the cerebral collateral recruitment, leading to the presence or absence of a lesion. This novel approach should greatly help preclinical studies to reduce animal variability. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Pulmonary ventilation/perfusion scan

    MedlinePlus

    ... JavaScript. A pulmonary ventilation/perfusion scan involves two nuclear scan tests to measure breathing (ventilation) and circulation ( ... In: Mettler FA, Guiberteau MJ, eds. Essentials of Nuclear Medicine Imaging . 6th ed. Philadelphia, PA: Elsevier Saunders; ...

  13. Central Fan Integrated Ventilation Systems

    SciTech Connect

    2009-05-12

    This information sheet describes one example of a ventilation system design, a central fan integrated supply (CFIS) system, a mechanical ventilation and pollutant source control to ensure that there is reasonable indoor air quality inside the house.

  14. How to Plan Ventilation Systems.

    ERIC Educational Resources Information Center

    Clarke, John H.

    1963-01-01

    Ventilation systems for factory safety demand careful planning. The increased heat loads and new processes of industry have introduced complex ventilation problems in--(1) ventilation supply, (2) duct work design, (3) space requirements, (4) hood face velocities, (5) discharge stacks, and (6) building eddies. This article describes and diagrams…

  15. How to Plan Ventilation Systems.

    ERIC Educational Resources Information Center

    Clarke, John H.

    1963-01-01

    Ventilation systems for factory safety demand careful planning. The increased heat loads and new processes of industry have introduced complex ventilation problems in--(1) ventilation supply, (2) duct work design, (3) space requirements, (4) hood face velocities, (5) discharge stacks, and (6) building eddies. This article describes and diagrams…

  16. Measure Guideline: Ventilation Cooling

    SciTech Connect

    Springer, D.; Dakin, B.; German, A.

    2012-04-01

    The purpose of this measure guideline on ventilation cooling is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

  17. Non-invasive ventilation.

    PubMed Central

    Spence, D.

    1996-01-01

    Nasal intermittent positive pressure ventilation is an effective treatment for nocturnal hypoventilation secondary to chest wall deformity or respiratory muscle weakness. Physicians should be aware that, in these groups of patients, disabling breathlessness can be alleviated and established cor pulmonale reversed by the technique. Images Figure 1 Figure 2 Figure 3 PMID:8949588

  18. Ventilator-associated pneumonia.

    PubMed

    Morehead, R S; Pinto, S J

    2000-07-10

    Ventilator-associated pneumonia is a common complication in intensive care units, occurring in 9% to 24% of patients intubated for longer than 48 hours. Because of this large disease burden and the resultant attributable morbidity and mortality, there is great interest in accurately diagnosing, treating, and preventing this complication. More severely ill patients tend to develop ventilator-associated pneumonia, and identified risk factors include prolonged mechanical ventilation, reintubation after failed extubation, and a few other clinical variables. The efficacy of diagnostic and preventive strategies is somewhat controversial. Diagnosis by invasive methods requires a considerable commitment of resources but can potentially reduce cost of care; however, mortality benefit from this approach has not been demonstrated. As such, in most institutions, ventilator-associated pneumonia is best diagnosed using traditional clinical criteria. Prompt administration of appropriate antibiotics seems to be the only intervention that alters outcome once the diagnosis is established. Several strategies seem to reduce pneumonia incidence; however, mortality and cost benefits have yet to be convincingly shown.

  19. Energy recovery ventilator

    SciTech Connect

    Schneider, S. L.; Dravnieks, K.

    1985-04-30

    An energy recovery ventilator adapted to be mounted on a roof and adapted to be connected to the outlet of an exhaust air duct of a building ventilation system and the inlet of an air supply duct of a building ventilation system. The energy recovery ventilator includes a housing having an exhaust air chamber and a supply air chamber separated by a divider wall. A circular heat transfer wheel is position in the housing, a portion of the wheel being housed in the exhaust air chamber and a second portion of the wheel being housed in the supply air chamber, and the heat transfer wheel is caused to rotate about a central axis. An exhaust fan is housed in the exhaust air chamber and causes exhaust air to be pulled through the exhaust air duct and the heat transfer wheel and to be exhausted from the housing. A supply air fan is housed in the supply air housing above the heat transfer wheel, and causes outside air to be drawn into the supply air chamber and to be forced through the heat transfer wheel into the air supply duct.

  20. Understanding mechanical ventilators.

    PubMed

    Chatburn, Robert L

    2010-12-01

    The respiratory care academic community has not yet adopted a standardized system for classifying and describing modes of ventilation. As a result, there is enough confusion that patient care, clinician education and even ventilator sales are all put at risk. This article summarizes a ventilator mode taxonomy that has been extensively published over the last 15 years. Specifically, the classification system has three components: a description of the control variables within breath; a description of the sequence of mandatory and spontaneous breaths; and a specification for the targeting scheme. This three-level specification provides scalability of detail to make the mode description appropriate for the particular need. At the bedside, we need only refer to a mode briefly using the first or perhaps first and second components. To distinguish between similar modes and brand names, we would need to include all components. This taxonomy uses the equation of motion for the respiratory system as the underlying theoretical framework. All terms relevant to describing modes of mechanical ventilation are defined in an extensive appendix.

  1. Laboratory Ventilation and Safety.

    ERIC Educational Resources Information Center

    Steere, Norman V.

    1965-01-01

    In order to meet the needs of both safety and economy, laboratory ventilation systems must effectively remove air-borne toxic and flammable materials and at the same time exhaust a minimum volume of air. Laboratory hoods are the most commonly used means of removing gases, dusts, mists, vapors, and fumed from laboratory operations. To be effective,…

  2. Space station ventilation study

    NASA Technical Reports Server (NTRS)

    Colombo, G. V.; Allen, G. E.

    1972-01-01

    A ventilation system design and selection method which is applicable to any manned vehicle were developed. The method was used to generate design options for the NASA 33-foot diameter space station, all of which meet the ventilation system design requirements. System characteristics such as weight, volume, and power were normalized to dollar costs for each option. Total system costs for the various options ranged from a worst case $8 million to a group of four which were all approximately $2 million. A system design was then chosen from the $2 million group and is presented in detail. A ventilation system layout was designed for the MSFC space station mockup which provided comfortable, efficient ventilation of the mockup. A conditioned air distribution system design for the 14-foot diameter modular space station, using the same techniques, is also presented. The tradeoff study resulted in the selection of a system which costs $1.9 million, as compared to the alternate configuration which would have cost $2.6 million.

  3. Adherence to the items in a bundle for the prevention of ventilator-associated pneumonia

    PubMed Central

    Sachetti, Amanda; Rech, Viviane; Dias, Alexandre Simões; Fontana, Caroline; Barbosa, Gilberto da Luz; Schlichting, Dionara

    2014-01-01

    Objective To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilatorassociated pneumonia. Methods A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia. Results Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389). Conclusion The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed. PMID:25607263

  4. Circuit Connectors

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The U-shaped wire devices in the upper photo are Digi-Klipsm; aids to compact packaging of electrical and electronic devices. They serve as connectors linking the circuitry of one circuit board with another in multi-board systems. Digi-Klips were originally developed for Goddard Space Flight Center to meet a need for lightweight, reliable connectors to replace hand-wired connections formerly used in spacecraft. They are made of beryllium copper wire, noted for its excellent conductivity and its spring-like properties, which assure solid electrical contact over a long period of time.

  5. Patient-ventilator dyssynchrony during assisted invasive mechanical ventilation.

    PubMed

    Murias, G; Villagra, A; Blanch, L

    2013-04-01

    Patient-ventilator dyssynchrony is common during mechanical ventilation. Dyssynchrony decreases comfort, prolongs mechanical ventilation and intensive care unit stays, and might lead to worse outcome. Dyssynchrony can occur during the triggering of the ventilator, the inspiration period after triggering, the transition from inspiration to expiration, and the expiratory phase. The most common dyssynchronies are delayed triggering, autotriggering, ineffective inspiratory efforts (which can occur at any point in the respiratory cycle), mismatch between the patient's and ventilator's inspiratory times, and double triggering. At present, the detection of dyssynchronies usually depends on healthcare staff observing ventilator waveforms; however, performance is suboptimal and many events go undetected. To date, technological complexity has made it impossible to evaluate patient-ventilator synchrony throughout the course of mechanical ventilation. Studies have shown that a high index of dyssynchrony may increase the duration of mechanical ventilation. Better training, better ventilatory modes, and/or computerized systems that permit better synchronization of patients' demands and ventilator outputs are necessary to improve patient-ventilator synchrony.

  6. LOGIC CIRCUIT

    DOEpatents

    Strong, G.H.; Faught, M.L.

    1963-12-24

    A device for safety rod counting in a nuclear reactor is described. A Wheatstone bridge circuit is adapted to prevent de-energizing the hopper coils of a ball backup system if safety rods, sufficient in total control effect, properly enter the reactor core to effect shut down. A plurality of resistances form one arm of the bridge, each resistance being associated with a particular safety rod and weighted in value according to the control effect of the particular safety rod. Switching means are used to switch each of the resistances in and out of the bridge circuit responsive to the presence of a particular safety rod in its effective position in the reactor core and responsive to the attainment of a predetermined velocity by a particular safety rod enroute to its effective position. The bridge is unbalanced in one direction during normal reactor operation prior to the generation of a scram signal and the switching means and resistances are adapted to unbalance the bridge in the opposite direction if the safety rods produce a predetermined amount of control effect in response to the scram signal. The bridge unbalance reversal is then utilized to prevent the actuation of the ball backup system, or, conversely, a failure of the safety rods to produce the predetermined effect produces no unbalance reversal and the ball backup system is actuated. (AEC)

  7. Minimum average 7-day, 10-year flows in the Hudson River basin, New York, with release-flow data on Rondout and Ashokan reservoirs

    USGS Publications Warehouse

    Archer, Roger J.

    1978-01-01

    Minimum average 7-day, 10-year flow at 67 gaging stations and 173 partial-record stations in the Hudson River basin are given in tabular form. Variation of the 7-day, 10-year low flow from point to point in selected reaches, and the corresponding times of travel, are shown graphically for Wawayanda Creek, Wallkill River, Woodbury-Moodna Creek, and the Fishkill Creek basins. The 7-day, 10-year low flow for the Saw Kill basin, and estimates of the 7-day, 10-year low flow of the Roeliff Jansen Kill at Ancram and of Birch Creek at Pine Hill, are given. Summaries of discharge from Rondout and Ashokan Reservoirs, in Ulster County, are also included. Minimum average 7-day, 10-year flow for gaging stations with 10 years or more of record were determined by log-Pearson Type III computation; those for partial-record stations were developed by correlation of discharge measurements made at the partial-record stations with discharge data from appropriate long-term gaging stations. The variation in low flows from point to point within the selected subbasins were estimated from available data and regional regression formula. Time of travel at these flows in the four subbasins was estimated from available data and Boning's equations.

  8. [The transdermal 7-day buprenorphine patch--an effective and safe treatment option, if tramadol or tilidate/naloxone is insufficient. Results of a non-interventional study].

    PubMed

    Schutter, U; Ritzdorf, I; Heckes, B

    2010-07-01

    The transdermal 7-day buprenorphine matrix patch provides a constant and user-friendly pain management when chronic musculoskeletal pain requires opioids. This analysis of clinical routine data evaluated the benefit of this treatment for patients previously receiving oral long-term treatment with weak opioids alone. Data of 310 patients previously treated with tramadol or tildate/naloxone and part of a multicentre observational study with 3295 patients were analyzed. In 89.7% of the 310 patients oral treatment with weak opioids was replaced by the 7-day buprenorphine patch due to insufficient analgesia. During treatment with the 7-day buprenorphine patch there was a clinically significant decrease of the mean pain intensity at rest during the day from 5.7 to 2.9, on physical effort during the day from 7.3 to 3.8 and at night from 5.2 to 2.3 (11-point NRS scale, p < or = 0.001). In addition, quality of life aspects such as mobility, self-reliance and quality of sleep improved, which are relevant for individual patient satisfaction with pain management. For patients with previous long-term tramadol or tilidate/naloxone treatment the switch to the 7-day buprenorphine matrix patch proved to be effective and safe for the management of chronic pain. The user-friendly 7-day application interval contributes to improving compliance and a reducing exposure to tablets.

  9. On the horizon: liquid ventilation.

    PubMed

    Eanes, R

    1995-02-01

    Studies in preterm animals and humans have shown that liquid ventilation is a potential alternative mode of support for neonates with respiratory failure. Perfluorochemicals have a high solubility for respiratory gases and can be instilled in the lung using lower pressures than with gas ventilation. Other potential advantages of liquid ventilation include decreased alveolar surface tension, improved pulmonary mechanics, alveolar recruitment, and the removal of pulmonary debris. This article describes in detail what liquid ventilation is, compares the physiologic effects of liquid ventilation to gas ventilation, and presents the nursing implications of this technique. A review of the recent literature on the subject is presented, including reports of laboratory and clinical experience with liquid ventilation.

  10. ASHRAE and residential ventilation

    SciTech Connect

    Sherman, Max H.

    2003-10-01

    In the last quarter of a century, the western world has become increasingly aware of environmental threats to health and safety. During this period, people psychologically retreated away from outdoors hazards such as pesticides, smog, lead, oil spills, and dioxin to the seeming security of their homes. However, the indoor environment may not be healthier than the outdoor environment, as has become more apparent over the past few years with issues such as mold, formaldehyde, and sick-building syndrome. While the built human environment has changed substantially over the past 10,000 years, human biology has not; poor indoor air quality creates health risks and can be uncomfortable. The human race has found, over time, that it is essential to manage the indoor environments of their homes. ASHRAE has long been in the business of ventilation, but most of the focus of that effort has been in the area of commercial and institutional buildings. Residential ventilation was traditionally not a major concern because it was felt that, between operable windows and envelope leakage, people were getting enough outside air in their homes. In the quarter of a century since the first oil shock, houses have gotten much more energy efficient. At the same time, the kinds of materials and functions in houses changed in character in response to people's needs. People became more environmentally conscious and aware not only about the resources they were consuming but about the environment in which they lived. All of these factors contributed to an increasing level of public concern about residential indoor air quality and ventilation. Where once there was an easy feeling about the residential indoor environment, there is now a desire to define levels of acceptability and performance. Many institutions--both public and private--have interests in Indoor Air Quality (IAQ), but ASHRAE, as the professional society that has had ventilation as part of its mission for over 100 years, is the

  11. A stream-gaging network analysis for the 7-day, 10-year annual low flow in New Hampshire streams

    USGS Publications Warehouse

    Flynn, Robert H.

    2003-01-01

    The 7-day, 10-year (7Q10) low-flow-frequency statistic is a widely used measure of surface-water availability in New Hampshire. Regression equations and basin-characteristic digital data sets were developed to help water-resource managers determine surface-water resources during periods of low flow in New Hampshire streams. These regression equations and data sets were developed to estimate streamflow statistics for the annual and seasonal low-flow-frequency, and period-of-record and seasonal period-of-record flow durations. generalized-least-squares (GLS) regression methods were used to develop the annual 7Q10 low-flow-frequency regression equation from 60 continuous-record stream-gaging stations in New Hampshire and in neighboring States. In the regression equation, the dependent variables were the annual 7Q10 flows at the 60 stream-gaging stations. The independent (or predictor) variables were objectively selected characteristics of the drainage basins that contribute flow to those stations. In contrast to ordinary-least-squares (OLS) regression analysis, GLS-developed estimating equations account for differences in length of record and spatial correlations among the flow-frequency statistics at the various stations.A total of 93 measurable drainage-basin characteristics were candidate independent variables. On the basis of several statistical parameters that were used to evaluate which combination of basin characteristics contribute the most to the predictive power of the equations, three drainage-basin characteristics were determined to be statistically significant predictors of the annual 7Q10: (1) total drainage area, (2) mean summer stream-gaging station precipitation from 1961 to 90, and (3) average mean annual basinwide temperature from 1961 to 1990.To evaluate the effectiveness of the stream-gaging network in providing regional streamflow data for the annual 7Q10, the computer program GLSNET (generalized-least-squares NETwork) was used to analyze the

  12. A stream-gaging network analysis for the 7-Day, 10-year annual low flow in New Hampshire streams

    USGS Publications Warehouse

    Flynn, Robert H.

    2003-01-01

    The 7-day, 10-year (7Q10) low-flow-frequency statistic is a widely used measure of surface-water availability in New Hampshire. Regression equations and basin-characteristic digital data sets were developed to help water-resource managers determine surface-water resources during periods of low flow in New Hampshire streams. These regression equations and data sets were developed to estimate streamflow statistics for the annual and seasonal low-flow-frequency, and period-of-record and seasonal period-of-record flow durations. generalized-least-squares (GLS) regression methods were used to develop the annual 7Q10 low-flow-frequency regression equation from 60 continuous-record stream-gaging stations in New Hampshire and in neighboring States. In the regression equation, the dependent variables were the annual 7Q10 flows at the 60 stream-gaging stations. The independent (or predictor) variables were objectively selected characteristics of the drainage basins that contribute flow to those stations. In contrast to ordinary-least-squares (OLS) regression analysis, GLS-developed estimating equations account for differences in length of record and spatial correlations among the flow-frequency statistics at the various stations. A total of 93 measurable drainage-basin characteristics were candidate independent variables. On the basis of several statistical parameters that were used to evaluate which combination of basin characteristics contribute the most to the predictive power of the equations, three drainage-basin characteristics were determined to be statistically significant predictors of the annual 7Q10: (1) total drainage area, (2) mean summer stream-gaging station precipitation from 1961 to 90, and (3) average mean annual basinwide temperature from 1961 to 1990. To evaluate the effectiveness of the stream-gaging network in providing regional streamflow data for the annual 7Q10, the computer program GLSNET (generalized-least-squares NETwork) was used to analyze the

  13. Test Protocol for Room-to-Room Distribution of Outside Air by Residential Ventilation Systems

    SciTech Connect

    Barley, C. D.; Anderson, R.; Hendron, B.; Hancock, E.

    2007-12-01

    This test and analysis protocol has been developed as a practical approach for measuring outside air distribution in homes. It has been used successfully in field tests and has led to significant insights on ventilation design issues. Performance advantages of more sophisticated ventilation systems over simpler, less-costly designs have been verified, and specific problems, such as airflow short-circuiting, have been identified.

  14. Gemifloxacin once daily for 5 days versus 7 days for the treatment of community-acquired pneumonia: a randomized, multicentre, double-blind study.

    PubMed

    File, Thomas M; Mandell, Lionel A; Tillotson, Glenn; Kostov, Kosta; Georgiev, Ognian

    2007-07-01

    Short-course therapy has been advocated for the treatment of community-acquired pneumonia (CAP). We compared the efficacy and safety of 5 and 7 day courses of gemifloxacin for outpatient treatment of mild-moderate CAP. In a multicentre, double-blind, parallel group study, patients were randomized to receive 320 mg of oral gemifloxacin once daily for 5 or 7 days. Over 95% of all patients in each cohort had a Fine score of 7 day treatments, respectively [95% confidence interval (CI) -1.48, 7.42], indicating non-inferiority of 5 day treatment. Clinical resolution at the end of therapy was 96% for both regimens (95% CI -3.85, 3.42). Bacteriological response rates in PP patients at the end of therapy were 94% and 96% for 5 and 7 day groups, respectively (95% CI -8.27, 3.25) and 91% for both groups at follow-up (95% CI -6.89, 7.93). Radiological success in PP patients at follow-up was 98% and 93% in 5 and 7 day groups, respectively (95% CI 0.35, 7.91). Pre-therapy pathogens were identified in 242 (47.3%) patients, most commonly Streptococcus pneumoniae. Frequency of treatment-related AEs was 21% in both cohorts with discontinuation rates of 1.2% and 2% in the 5 and 7 day groups, respectively. A lower incidence of rash was observed in the 5 day cohort (0.4%) versus the 7 day cohort (2.8%) (P=0.04). Gemifloxacin once daily for 5 days is not inferior to 7 days in the PP population with respect to clinical, bacteriological and radiological efficacy. Further work is needed, however, to explore whether fewer treatment days would improve patient compliance and reduce the incidence of AEs.

  15. The microbiological and sustainability effects of washing anaesthesia breathing circuits less frequently.

    PubMed

    McGain, F; Algie, C M; O'Toole, J; Lim, T F; Mohebbi, M; Story, D A; Leder, K

    2014-04-01

    In the presence of single-use airway filters, we quantified anaesthetic circuit aerobic microbial contamination rates when changed every 24 h, 48 h and 7 days. Microbiological samples were taken from the interior of 305 anaesthetic breathing circuits over a 15-month period (3197 operations). There was no significant difference in the proportion of contaminated circuits when changed every 24 h (57/105 (54%, 95% CI 45-64%)) compared with 48 h (43/100 (43%, 95% CI 33-53%, p = 0.12)) and up to 7 days (46/100 (46%, 95% CI 36-56%, p = 0.26)). Median bacterial counts were not increased at 48 h or 7 days provided circuits were routinely emptied of condensate. Annual savings for one hospital (six operating theatres) were $AU 5219 (£3079, €3654, $US 4846) and a 57% decrease in anaesthesia circuit steriliser loads associated with a yearly saving of 2760 kWh of electricity and 48 000 l of water. Our findings suggest that extended circuit use from 24 h up to 7 days does not significantly increase bacterial contamination, and is associated with labour, energy, water and financial savings. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

  16. [Non-invasive ventilation].

    PubMed

    Gallardo Romero, Jose Manuel; García, Teresa Gómez; Sancho Chust, José Norberto; González Martínez, Mónica

    2010-10-01

    The advent of non-invasive mechanical ventilation (NIMV) has radically changed the management of acute and chronic respiratory failure. Over the last few years, the number of possible applications of NIMV has progressively increased, both in the hospital and extrahospital setting. NIMV is now used in all hospitals and resident physicians currently receive specific training -nonexistent until a few years ago- in this modality. It falls to all of us to push forward the clinical and scientific advances represented by the development of NIMV, by promoting the events that accompany better knowledge of the physiopathological bases of ventilation and of its continuous applications in daily clinical practice and by perfecting the elements required for the correct application of this technique. The present review aims to provide a broad overview of NIMV, from the most theoretical knowledge (the physiopathology of NIMV) to the most practical skills (recognition of patient-ventilator asynchrony). Through this progression from the complex to the most basic, or from the basics to the most complex, depending on the perspective taken, we aim to provide deeper knowledge of the concepts required to understand the technical functioning of the ventilator, describing its distinct modes and parameters and the abilities that must be developed for the correct indication, use and monitoring of the technique. We provide a final reflection on other forms of respiratory support that can be offered to patients with ventilatory failure. Copyright © 2010 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

  17. Oven ventilation system

    SciTech Connect

    Brewer, D.E.

    1987-02-17

    A ventilation system is described for venting an oven with external surfaces, the oven being located within an enclosed space, the system comprising: intake means for collecting air from the external environment of the enclosed space; means for forming a sheet of the air and passing the sheet across the external surfaces of the oven; and exhaust means for exhausting the sheet of the air to the external environment of the enclosed space after the air has been passed across the external surfaces.

  18. Harnessing natural ventilation benefits.

    PubMed

    O'Leary, John

    2013-04-01

    Making sure that a healthcare establishment has a good supply of clean fresh air is an important factor in keeping patients, staff, and visitors, free from the negative effects of CO2 and other contaminants. John O'Leary of Trend Controls, a major international supplier of building energy management solutions (BEMS), examines the growing use of natural ventilation, and the health, energy-saving, and financial benefits, that it offers.

  19. Commutation circuit for an HVDC circuit breaker

    DOEpatents

    Premerlani, William J.

    1981-01-01

    A commutation circuit for a high voltage DC circuit breaker incorporates a resistor capacitor combination and a charging circuit connected to the main breaker, such that a commutating capacitor is discharged in opposition to the load current to force the current in an arc after breaker opening to zero to facilitate arc interruption. In a particular embodiment, a normally open commutating circuit is connected across the contacts of a main DC circuit breaker to absorb the inductive system energy trapped by breaker opening and to limit recovery voltages to a level tolerable by the commutating circuit components.

  20. Commutation circuit for an HVDC circuit breaker

    DOEpatents

    Premerlani, W.J.

    1981-11-10

    A commutation circuit for a high voltage DC circuit breaker incorporates a resistor capacitor combination and a charging circuit connected to the main breaker, such that a commutating capacitor is discharged in opposition to the load current to force the current in an arc after breaker opening to zero to facilitate arc interruption. In a particular embodiment, a normally open commutating circuit is connected across the contacts of a main DC circuit breaker to absorb the inductive system energy trapped by breaker opening and to limit recovery voltages to a level tolerable by the commutating circuit components. 13 figs.

  1. Commutation circuit for an HVDC circuit breaker

    SciTech Connect

    Premerlani, W.J.

    1981-11-10

    A commutation circuit for a high voltage DC circuit breaker incorporates a resistor capacitor combination and a charging circuit connected to the main breaker, such that a commutating capacitor is discharged in opposition to the load current to force the current in an arc after breaker opening to zero to facilitate arc interruption. In a particular embodiment, a normally open commutating circuit is connected across the contacts of a main DC circuit breaker to absorb the inductive system energy trapped by breaker opening and to limit recovery voltages to a level tolerable by the commutating circuit components. 13 figs.

  2. Home Mechanical Ventilation in Children.

    PubMed

    Preutthipan, Aroonwan

    2015-09-01

    The number of children dependent on home mechanical ventilation has been reported to be increasing in many countries around the world. Home mechanical ventilation has been well accepted as a standard treatment of children with chronic respiratory failure. Some children may need mechanical ventilation as a lifelong therapy. To send mechanically ventilated children back home may be more difficult than adults. However, relatively better outcomes have been demonstrated in children. Children could be safely ventilated at home if they are selected and managed properly. Conditions requiring home ventilation include increased respiratory load from airway or lung pathologies, ventilatory muscle weakness and failure of neurologic control of ventilation. Home mechanical ventilation should be considered when the patient develops progressive respiratory failure or intractable failure to wean mechanical ventilation. Polysomnography or overnight pulse oximetry plus capnometry are used to detect nocturnal hypoventilation in early stage of respiratory failure. Ventilator strategy including non-invasive and invasive approach should be individualized for each patient. The author strongly believes that parents and family members are able to take care of their child at home if they are trained and educated effectively. A good team work with dedicated members is the key factor of success.

  3. Diaphragmatic dysfunction in mechanical ventilation.

    PubMed

    Haitsma, Jack J

    2011-04-01

    It has become clear from experimental data that prolonged mechanical ventilation can induce diaphragm dysfunction, also known as ventilator-induced diaphragm dysfunction. In this article we will discuss most recent understanding on ventilator-induced diaphragm dysfunction and data on diaphragm dysfunction in patients. Over the last year several studies confirmed the existence of diaphragm dysfunction in patients. Known atrophy pathways are activated in patients undergoing prolonged conventional ventilation resulting in muscle proteolysis and a decrease in myofiber content. The loss of diaphragm force is time-dependent, but current data do not distinguish between the role played by other factors involved in diaphragm dysfunction. Diaphragm dysfunction occurs in patients, especially when ventilated with controlled modes of ventilation that minimize diaphragm activity. Time on the ventilator seems to be one of the biggest risk factors resulting in difficulties in weaning patients and prolonging time on the ventilator. Future trials should investigate whether improved patient-ventilator synchrony can reduce ventilator-induced diaphragm dysfunction and decrease weaning failure.

  4. Control technology for integrated circuit fabrication at Micro-Circuit Engineering, Incorporated, West Palm Beach, Florida

    NASA Astrophysics Data System (ADS)

    Mihlan, G. I.; Mitchell, R. I.; Smith, R. K.

    1984-07-01

    A survey to assess control technology for integrated circuit fabrication was conducted. Engineering controls included local and general exhaust ventilation, shielding, and personal protective equipment. Devices or work stations that contained toxic materials that were potentially dangerous were controlled by local exhaust ventilation. Less hazardous areas were controlled by general exhaust ventilation. Process isolation was used in the plasma etching, low pressure chemical vapor deposition, and metallization operations. Shielding was used in ion implantation units to control X-ray emissions, in contact mask alignes to limit ultraviolet (UV) emissions, and in plasma etching units to control radiofrequency and UV emissions. Most operations were automated. Use of personal protective equipment varied by job function.

  5. Ventilators for noninvasive ventilation to treat acute respiratory failure.

    PubMed

    Scala, Raffaele; Naldi, Mario

    2008-08-01

    The application of noninvasive ventilation (NIV) to treat acute respiratory failure has increased tremendously both inside and outside the intensive care unit. The choice of ventilator is crucial for success of NIV in the acute setting, because poor tolerance and excessive air leaks are significantly correlated with NIV failure. Patient-ventilator asynchrony and discomfort can occur if the physician or respiratory therapist fails to adequately set NIV to respond to the patient's ventilatory demand, so clinicians need to fully understood the ventilator's technical peculiarities (eg, efficiency of trigger and cycle systems, speed of pressurization, air-leak compensation, CO(2) rebreathing, reliability of fraction of inspired oxygen reading, monitoring accuracy). A wide range of ventilators of different complexity have been introduced into clinical practice to noninvasively support patients in acute respiratory failure, but the numerous commercially available ventilators (bi-level, intermediate, and intensive care unit ventilators) have substantial differences that can influence patient comfort, patient-ventilator interaction, and, thus, the chance of NIV clinical success. This report examines the most relevant aspects of the historical evolution, the equipment, and the acute-respiratory-failure clinical application of NIV ventilators.

  6. [Analysis of the risk factors of pulmonary fungal infections related to mechanical ventilation and prognosis of the patients].

    PubMed

    Li, Ming; Chen, Zhuang-gui; Zhang, Chang-ran; Lin, Jian-cong; Zeng, Mian

    2008-03-01

    To investigate the risk factors of pulmonary fungal infections related to mechanical ventilation and the prognosis of patients. A retrospective case-controlled study was conducted to analyze the culture results of the pulmonary secretions in patients with pulmonary fungal and nonfungal infections in association with mechanical ventilations. The risk factors of pulmonary fungal infections related to mechanical ventilation were identified and their impact on the clinical outcome of the patients was evaluated. Of the 127 patients included in this study, 81 (63.78%) were positive and 46 (36.22%) negative for pulmonary fungal infections according to the diagnostic criteria of ventilator-associated pneumonia (VAP). The mortality of the patients with fungal infection was 82.7%, significantly higher than that of patients with non-fungal infection (67.39%, chi2=3.910, P<0.05). Univariate analysis and multivariate logistic regression showed that such factors as old age, duration of mechanical ventilation, tracheal intubation or incision for over 7 days, diabetes, blood glucose over 6.1 mmol/L, multi-organ dysfunction, combined use of antibiotics, at least 3-time changes antibiotics, administration of glucocorticosteroid for over 7 days, and immunodepressant use were all the independence risk factors of pulmonary fungal infection related to mechanical ventilation. Old age, multi-organ dysfunction, blood glucose over 6.1 mmol/L, glucocorticosteroid use for over 7 days, anesthetic use for over 3 days and high APACHE III scores were the risk factors for mortality in patients with the infections. Pulmonary fungal infection associated to mechanical ventilation is often the results of presence of multiple risk factors, and early identification of these factors for timely antifungal treatment may improve the prognostics of the patients and help reduce the mortality rate.

  7. A simple tachometer circuit

    NASA Technical Reports Server (NTRS)

    Dimeff, J.

    1972-01-01

    Electric circuit to measure frequency of repetitive sinusoidal or rectangular wave is presented. Components of electric circuit and method of operation are explained. Application of circuit as tachometer for automobile is discussed.

  8. Circuit monitors powerline interruptions

    NASA Technical Reports Server (NTRS)

    Simmons, N. E.; Stricklen, J. O.

    1977-01-01

    Simple circuit when combined with pulse detector detects momentary interruptions of 400-cycle ac signal. Circuit has been used during shock and vibration testing of electronic hardware to determine if tests caused interruptions of normal circuit operation.

  9. Photomultiplier blanking circuit

    NASA Technical Reports Server (NTRS)

    Mcclenahan, J. O.

    1972-01-01

    Circuit for protecting photomultiplier equipment from current surges which occur when exposed to brilliant illumination is discussed. Components of circuit and details of operation are provided. Circuit diagram to show action of blanking pulse on zener diode is included.

  10. Circuit monitors powerline interruptions

    NASA Technical Reports Server (NTRS)

    Simmons, N. E.; Stricklen, J. O.

    1977-01-01

    Simple circuit when combined with pulse detector detects momentary interruptions of 400-cycle ac signal. Circuit has been used during shock and vibration testing of electronic hardware to determine if tests caused interruptions of normal circuit operation.

  11. Predicting wildfire ignitions, escapes, and large fire activity using Predictive Service’s 7-Day Fire Potential Outlook in the western USA

    Treesearch

    Karin L. Riley; Crystal Stonesifer; Haiganoush Preisler; Dave Calkin

    2014-01-01

    Can fire potential forecasts assist with pre-positioning of fire suppression resources, which could result in a cost savings to the United States government? Here, we present a preliminary assessment of the 7-Day Fire Potential Outlook forecasts made by the Predictive Services program. We utilized historical fire occurrence data and archived forecasts to assess how...

  12. Estimates of the demand for mechanical ventilation in the US during an influenza pandemic

    PubMed Central

    Meltzer, Martin I.; Patel, Anita; Koonin, Lisa M.

    2015-01-01

    An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9) virus provided reason for U.S. public health officials to revisit existing national pandemic response plans. We built a spreadsheet model to examine the potential demand for invasive mechanical ventilation (excluding “rescue therapy" ventilation). We considered scenarios of either 20% or 30% gross influenza clinical attack rate (CAR), with a “low severity” scenario with case fatality rates (CFR) of 0.05%–0.1%, or a “high severity” scenario (CFR: 0.25%–0.5%). We used rates-of-influenza-related illness to calculate the numbers of potential clinical cases, hospitalizations, admissions to intensive care units (ICUs), and need for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13% of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7,000 to 11,000 ventilators will be needed, averting a pandemic total of 35,000 to 55,000 deaths. A 30% CAR, high severity scenario, will need approximately 35,000 to 60,500 additional ventilators, averting a pandemic total 178,000 to 308,000 deaths. Estimates of deaths averted may not be realized because successful ventilation also depends on sufficient numbers of suitably trained staff, needed supplies (e.g., drugs, reliable oxygen sources, suction apparatus, circuits, and monitoring equipment) and timely ability to match access to ventilators with critically ill cases. There is a clear challenge to plan and prepare to meet demands for mechanical ventilators for a future severe pandemic. PMID:25878301

  13. Estimates of the demand for mechanical ventilation in the United States during an influenza pandemic.

    PubMed

    Meltzer, Martin I; Patel, Anita; Ajao, Adebola; Nystrom, Scott V; Koonin, Lisa M

    2015-05-01

    An outbreak in China in April 2013 of human illnesses due to avian influenza A(H7N9) virus provided reason for US public health officials to revisit existing national pandemic response plans. We built a spreadsheet model to examine the potential demand for invasive mechanical ventilation (excluding "rescue therapy" ventilation). We considered scenarios of either 20% or 30% gross influenza clinical attack rate (CAR), with a "low severity" scenario with case fatality rates (CFR) of 0.05%-0.1%, or a "high severity" scenario (CFR: 0.25%-0.5%). We used rates-of-influenza-related illness to calculate the numbers of potential clinical cases, hospitalizations, admissions to intensive care units, and need for mechanical ventilation. We assumed 10 days ventilator use per ventilated patient, 13% of total ventilator demand will occur at peak, and a 33.7% weighted average mortality risk while on a ventilator. At peak, for a 20% CAR, low severity scenario, an additional 7000 to 11,000 ventilators will be needed, averting a pandemic total of 35,000 to 55,000 deaths. A 30% CAR, high severity scenario, will need approximately 35,000 to 60,500 additional ventilators, averting a pandemic total 178,000 to 308,000 deaths. Estimates of deaths averted may not be realized because successful ventilation also depends on sufficient numbers of suitably trained staff, needed supplies (eg, drugs, reliable oxygen sources, suction apparatus, circuits, and monitoring equipment) and timely ability to match access to ventilators with critically ill cases. There is a clear challenge to plan and prepare to meet demands for mechanical ventilators for a future severe pandemic.

  14. Pulmonary mechanics during mechanical ventilation.

    PubMed

    Henderson, William R; Sheel, A William

    2012-03-15

    The use of mechanical ventilation has become widespread in the management of hypoxic respiratory failure. Investigations of pulmonary mechanics in this clinical scenario have demonstrated that there are significant differences in compliance, resistance and gas flow when compared with normal subjects. This paper will review the mechanisms by which pulmonary mechanics are assessed in mechanically ventilated patients and will review how the data can be used for investigative research purposes as well as to inform rational ventilator management.

  15. [Jet ventilation in laryngotracheal surgery].

    PubMed

    Friedrich, G; Mausser, G; Gugatschka, M

    2008-12-01

    Conventional endotracheal intubation can be a limiting factor in endolaryngeal and endotracheal surgery. Tubeless jet ventilation can overcome this problem and provides an unlimited operation field to the surgeon. Since the development of first jet ventilation systems, many modifications have been performed and are used permanently in daily clinical routine. The aim of this work is to provide an overview of widely used jet ventilation systems and furthermore to list all advantages, as well as disadvantages of this technique in laryngotracheal surgery.

  16. 46 CFR 111.105-21 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Ventilation. 111.105-21 Section 111.105-21 Shipping... REQUIREMENTS Hazardous Locations § 111.105-21 Ventilation. A ventilation duct which ventilates a hazardous location has the classification of that location. Each fan for ventilation of a hazardous location must...

  17. 46 CFR 111.105-21 - Ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Ventilation. 111.105-21 Section 111.105-21 Shipping... REQUIREMENTS Hazardous Locations § 111.105-21 Ventilation. A ventilation duct which ventilates a hazardous location has the classification of that location. Each fan for ventilation of a hazardous location must...

  18. 46 CFR 111.105-21 - Ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Ventilation. 111.105-21 Section 111.105-21 Shipping... REQUIREMENTS Hazardous Locations § 111.105-21 Ventilation. A ventilation duct which ventilates a hazardous location has the classification of that location. Each fan for ventilation of a hazardous location must...

  19. Field measurement of ventilation rates.

    PubMed

    Persily, A K

    2016-02-01

    Ventilation rates have significant impacts on building energy use and indoor contaminant concentrations, making them key parameters in building performance. Ventilation rates have been measured in buildings for many decades, and there are mature measurement approaches available to researchers and others who need to know actual ventilation rates in buildings. Despite the fact that ventilation rates are critical in interpreting indoor concentration measurements, it is disconcerting how few Indoor Air Quality field studies measure ventilation rates or otherwise characterize the ventilation design of the study building(s). This paper summarizes parameters of interest in characterizing building ventilation, available methods for quantifying these parameters, and challenges in applying these methods to different types of buildings and ventilation systems. These parameters include whole-building air change rates, system outdoor air intake rates, and building infiltration rates. Tracer gas methods are reviewed as well as system airflow rate measurements using, for example, duct traverses. Several field studies of ventilation rates conducted over the past 75 years are described to highlight the approaches employed and the findings obtained.

  20. Ventilation heterogeneity in obesity.

    PubMed

    Pellegrino, Riccardo; Gobbi, Alessandro; Antonelli, Andrea; Torchio, Roberto; Gulotta, Carlo; Pellegrino, Giulia Michela; Dellacà, Raffaele; Hyatt, Robert E; Brusasco, Vito

    2014-05-01

    Obesity is associated with important decrements in lung volumes. Despite this, ventilation remains normally or near normally distributed at least for moderate decrements in functional residual capacity (FRC). We tested the hypothesis that this is because maximum flow increases presumably as a result of an increased lung elastic recoil. Forced expiratory flows corrected for thoracic gas compression volume, lung volumes, and forced oscillation technique at 5-11-19 Hz were measured in 133 healthy subjects with a body mass index (BMI) ranging from 18 to 50 kg/m(2). Short-term temporal variability of ventilation heterogeneity was estimated from the interquartile range of the frequency distribution of the difference in inspiratory resistance between 5 and 19 Hz (R5-19_IQR). FRC % predicted negatively correlated with BMI (r = -0.72, P < 0.001) and with an increase in slope of either maximal (r = -0.34, P < 0.01) or partial flow-volume curves (r = -0.30, P < 0.01). Together with a slight decrease in residual volume, this suggests an increased lung elastic recoil. Regression analysis of R5-19_IQR against FRC % predicted and expiratory reserve volume (ERV) yielded significantly higher correlation coefficients by nonlinear than linear fitting models (r(2) = 0.40 vs. 0.30 for FRC % predicted and r(2) = 0.28 vs. 0.19 for ERV). In conclusion, temporal variability of ventilation heterogeneities increases in obesity only when FRC falls approximately below 65% of predicted or ERV below 0.6 liters. Above these thresholds distribution is quite well preserved presumably as a result of an increase in lung recoil.

  1. Atelectasis and mechanical ventilation mode during conservative oxygen therapy: A before-and-after study.

    PubMed

    Suzuki, Satoshi; Eastwood, Glenn M; Goodwin, Mark D; Noë, Geertje D; Smith, Paul E; Glassford, Neil; Schneider, Antoine G; Bellomo, Rinaldo

    2015-12-01

    The purpose of the study is to assess the effect of a conservative oxygen therapy (COT) (target SpO2 of 90%-92%) on radiological atelectasis and mechanical ventilation modes. We conducted a secondary analysis of 105 intensive care unit patients from a pilot before-and-after study. The primary outcomes of this study were changes in atelectasis score (AS) of 555 chest radiographs assessed by radiologists blinded to treatment allocation and time to weaning from mandatory ventilation and first spontaneous ventilation trial (SVT). There was a significant difference in overall AS between groups, and COT was associated with lower time-weighted average AS. In addition, in COT patients, change from mandatory to spontaneous ventilation or time to first SVT was shortened. After adjustment for baseline characteristics and interactions between oxygen therapy, radiological atelectasis, and mechanical ventilation management, patients in the COT group had significantly lower "best" AS (adjusted odds ratio, 0.28 [95% confidence interval {CI}, 0.12-0.66]; P=.003) and greater improvement in AS in the first 7 days (adjusted odds ratio, 0.42 [95% CI, 0.17-0.99]; P=.049). Moreover, COT was associated with significantly earlier successful weaning from a mandatory ventilation mode (adjusted hazard ratio, 2.96 [95% CI, 1.73-5.04]; P<.001) and with shorter time to first SVT (adjusted hazard ratio, 1.77 [95% CI, 1.13-2.78]; P=.013). In mechanically ventilated intensive care unit patients, COT might be associated with decreased radiological evidence of atelectasis, earlier weaning from mandatory ventilation modes, and earlier first trial of spontaneous ventilation. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Ventilated Oscillatory Boundary Layers

    DTIC Science & Technology

    1993-02-01

    AD-A266 226IllII !i III ll11111 II •" Ventilated Oscillatory Boundary Layers 0 Daniel -. Conley Douglas L. I nman C 0 UM U U U U till 1% w 1% W" Z t...A SIGNIFICANT NUMBER OF PAGES WHICH DO NOT REPRODUCE LEGIBLY. VENlTILATiD SCIILLAORY BOUNDARY LAYERS Daniel C. C7onley DoL’laN L. . ... La olDla...Wave Crest ........ 5. Boundary Layer Development Under the Wave Trough W 6 . Laboratory Observations .................. ................ 7

  3. Laboratory and Industrial Ventilation

    NASA Technical Reports Server (NTRS)

    1972-01-01

    This handbook supplements the Facilities Engineering Handbook (NHB 7320.1) and provides additional policies and criteria for uniform application to ventilation systems. It expands basic requirements, provides additional design and construction guidance, and places emphasis on those design considerations which will provide for greater effectiveness in the use of these systems. The provisions of this handbook are applicable to all NASA field installations and the Jet Propulsion Laboratory. Since supply of this handbook is limited, abstracts of the portion or portions applicable to a given requirement will be made for the individual specific needs encountered rather than supplying copies of the handbook as has been past practice.

  4. Radioaerosol ventilation imaging in ventilator-dependent patients. Technical considerations

    SciTech Connect

    Vezina, W.; Chamberlain, M.; Vinitski, S.; King, M.; Nicholson, R.; Morgan, W.K.

    1985-11-01

    The differentiation of pulmonary embolism (PE) from regional ventilatory abnormalities accompanied by reduced perfusion requires contemporary perfusion and ventilation studies. Distinguishing these conditions in ventilator-dependent patients is aided by administering a Tc-99m aerosol to characterize regional ventilation, and by performing a conventional Tc-99m MAA perfusion study. The technique uses a simple in-house constructed apparatus. Simple photographic techniques suffice, but computer subtraction of perfusion from the combined perfusion-ventilation image renders interpretation easier if aerosol administration follows perfusion imaging. Multiple defects can be examined in a single study. Excluding normal or near-normal perfusion studies, PE was thought to be present in eight of 16 patients after perfusion imaging alone, but in only one of eight after added aerosol imaging. Angiography confirmed the diagnosis in that patient. Of the eight patients who had abnormal perfusion but were thought unlikely to have PE from the perfusion study alone, two had normal ventilation, and subsequently were shown to have PE by angiography. Because angiography was only performed on patients who were thought to have a high probability of PE on sequential perfusion-ventilation imaging, the true incidence of PE may have been higher. Aerosol ventilation imaging is a useful adjunct to perfusion imaging in patients on ventilators. It requires an efficient delivery system, particularly if aerosol administration follows perfusion imaging, as it does in this study.

  5. Effect of outside air ventilation rate on VOC concentrations and emissions in a call center

    SciTech Connect

    Hodgson, A.T.; Faulkner, D.; Sullivan, D.P.; DiBartolomeo, D.L.; Russell, M.L.; Fisk, W.J.

    2002-01-01

    A study of the relationship between outside air ventilation rate and concentrations of VOCs generated indoors was conducted in a call center. Ventilation rates were manipulated in the building's four air handling units (AHUs). Concentrations of VOCs in the AHU returns were measured on 7 days during a 13-week period. Indoor minus outdoor concentrations and emission factors were calculated. The emission factor data was subjected to principal component analysis to identify groups of co-varying compounds based on source type. One vector represented emissions of solvents from cleaning products. Another vector identified occupant sources. Direct relationships between ventilation rate and concentrations were not observed for most of the abundant VOCs. This result emphasizes the importance of source control measures for limiting VOC concentrations in buildings.

  6. Effects of a mouthwash with chlorine dioxide on oral malodor and salivary bacteria: a randomized placebo-controlled 7-day trial

    PubMed Central

    2010-01-01

    Background Previous research has shown the oxidizing properties and microbiological efficacies of chlorine dioxide (ClO2). Its clinical efficacies on oral malodor have been evaluated and reported only in short duration trials, moreover, no clinical studies have investigated its microbiological efficacies on periodontal and malodorous bacteria. Thus, the aim of this study was to assess the inhibitory effects of a mouthwash containing ClO2 used for 7 days on morning oral malodor and on salivary periodontal and malodorous bacteria. Methods/Design A randomized, double blind, crossover, placebo-controlled trial was conducted among 15 healthy male volunteers, who were divided into 2 groups. Subjects were instructed to rinse with the experimental mouthwash containing ClO2 or the placebo mouthwash, without ClO2, twice per day for 7 days. After a one week washout period, each group then used the opposite mouthwash for 7 days. At baseline and after 7 days, oral malodor was evaluated with Organoleptic measurement (OM), and analyzed the concentrations of hydrogen sulfide (H2S), methyl mercaptan (CH3SH) and dimethyl sulfide ((CH3)2S), the main VSCs of human oral malodor, were assessed by gas chromatography (GC). Clinical outcome variables included plaque and gingival indices, and tongue coating index. The samples of saliva were microbiologically investigated. Quantitative and qualitative analyses were performed using the polymerase chain reaction-Invader method. Results and Discussion The baseline oral condition in healthy subjects in the 2 groups did not differ significantly. After rinsing with the mouthwash containing ClO2 for 7 days, morning bad breath decreased as measured by the OM and reduced the concentrations of H2S, CH3SH and (CH3)2S measured by GC, were found. Moreover ClO2 mouthwash used over a 7-day period appeared effective in reducing plaque, tongue coating accumulation and the counts of Fusobacterium nucleatum in saliva. Future research is needed to examine long

  7. [Facial or nasal mask pressure support ventilation in managing acute exacerbation of chronic respiratory failure in chronic obstructive pulmonary diseases].

    PubMed

    Chen, R C

    1992-10-01

    11 COPD patients (age: 65 +/- 9 Yrs) with acute exacerbation of chronic respiratory failure (PaCO2 11.3 +/- 1.1kPa) were treated with mask pressure support ventilation, another 10 similar patients (age: 68 +/- 12 Yrs) served as control. BiPAP ventilator was used with the following modifications: (1) Non-rebreathing valve set-in proximal to mask; (2) 5 LPM oxygen flow delivered into mask to reduce the dead space effect. Mask ventilation was given 2-3 hours every time and 1-2 time daily for 7 days. Synchrony and airway patency were specially monitored. The results suggested that mask ventilation could reduce PaCO2, improve PaO2, relieve dyspnea and decrease the possibility of intubation.

  8. Fuselage ventilation under wind conditions

    NASA Technical Reports Server (NTRS)

    Stuart, J. W.

    1979-01-01

    To determine realistic fuselage ventilation rates for post-crash fires and full-scale fire tests, the effects on wind-about fuselage ventilation rate of various parameters were studied. The parameters investigated were fuselage size and shape, fuselage orientation and proximity to ground, fuselage-opening and location, and wind speed and direction.

  9. Transpired Air Collectors - Ventilation Preheating

    SciTech Connect

    Christensen, C.

    2006-06-22

    Many commercial and industrial buildings have high ventilation rates. Although all that fresh air is great for indoor air quality, heating it can be very expensive. This short (2-page) fact sheet describes a technology available to use solar energy to preheat ventilation air and dramatically reduce utility bills.

  10. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  11. Evaluation of building ventilation systems

    SciTech Connect

    Hughes, R.T.; O'Brien, D.M.

    1986-04-01

    Over the past several years, NIOSH has responded to health hazard evaluation requests from workers in dozens of office environments. Typically, the employees have complained of headache, eye and upper respiratory tract irritation, dizziness, lethargy and the inability to concentrate. Most often inadequate ventilation has been blamed for these complaints. Of paramount importance in the evaluation and correction of these problems is an effective evaluation of the building's ventilation system. Heating, ventilating and air-conditioning conditions that can cause worker stresses include: migration of odors or chemical hazards between building areas; reentrainment of exhaust from building fume hoods or through heat wheels; buildup of microorganisms in the HVAC system components; and poor odor or environmental control due to insufficient fresh outdoor air or system heating or cooling malfunction. The purpose of this paper is to provide an overview of building ventilation systems, the ventilation problems associated with poorly designed or operating systems, and the methodology for effectively evaluating system performance.

  12. Randomized masked controlled clinical trial to compare 7-day and 14-day course length of doxycycline in the treatment of Mycoplasma felis infection in shelter cats.

    PubMed

    Kompare, B; Litster, A L; Leutenegger, C M; Weng, H-Y

    2013-03-01

    The aim of this study was to compare the clinical and microbial efficacy of a 7-day or a 14-day course of doxycycline for the treatment of Mycoplasma felis-infected cats with clinical signs of upper respiratory tract disease (URTD) assessed using clinical scoring criteria. Cats were randomly allocated to either the Doxy-7 group (N=20; 7-day course of oral doxycyline liquid followed by 7-days placebo); or the Doxy-14 group (N=20; 14-day course of oral doxycycline). There were no significant differences in Mycoplasma load between groups at Day 1 or Day 7 (P>0.05), but at Day 14 mean Mycoplasma load was lower in the Doxy-14 group (P=0.01). Mycoplasma load reduced over Days 1-7 in each group (P<0.01), but only the Doxy-14 group had a significantly reduced Mycoplasma load at Day 14 compared to Day 1 (P<0.01). On Day 14, 11 (55%) cats in the Doxy-7 group and 5 (25%) cats in the Doxy-14 group had positive PCR results for M. felis. There was a statistically significant reduction within each group across the Day 1-7 period for ocular discharge, nasal discharge, demeanor, and food intake scores (P<0.01 for each score category). Nasal discharge scores and sneezing scores were statistically lower in the Doxy-14 group than in the Doxy-7 group on individual days during the Day 8-14 period (P<0.05). We conclude that in M. felis-infected cats with clinical signs of URTD, a 14-day course of oral doxycycline produced superior microbial but not clinical results compared to a 7-day course of treatment.

  13. A RANDOMIZED TREATMENT TRIAL: SINGLE VERSUS 7 DAY DOSE OF METRONIDAZOLE FOR THE TREATMENT OF TRICHOMONAS VAGINALIS AMONG HIV-INFECTED WOMEN

    PubMed Central

    Kissinger, Patricia; Mena, Leandro; Levison, Judy; Clark, Rebecca A.; Gatski, Megan; Henderson, Harold; Schmidt, Norine; Rosenthal, Susan; Myers, Leann; Martin, David H.

    2010-01-01

    Objective To determine if the metronidazole (MTZ) 2 gm single dose (recommended) is as effective as the 7 day 500 mg BID dose (alternative) for treatment of Trichomonas vaginalis (TV) among HIV+ women. Methods Phase IV randomized clinical trial; HIV+ women with culture confirmed TV were randomized to treatment arm: MTZ 2 gm single dose or MTZ 500 mg BID 7 day dose. All women were given 2 gm MTZ doses to deliver to their sex partners. Women were re-cultured for TV at a test-of-cure (TOC) visit occurring 6-12 days after treatment completion. TV-negative women at TOC were again re-cultured at a 3 month visit. Repeat TV infection rates were compared between arms. Results 270 HIV+/TV+ women were enrolled (mean age = 40 years, ± 9.4; 92.2% African-American). Treatment arms were similar with respect to age, race, CD4 count, viral load, ART status, site, and loss-to-follow up. Women in the 7 day arm had: lower repeat TV infection rates at TOC [8.5% (11/130) versus 16.8% (21/125) (R.R. 0.50, 95% CI=0.25, 1.00; P<0.05)], and at 3 months [11.0% (8/73) versus 24.1% (19/79) (R.R. 0.46, 95% CI=0.21, 0.98; P=0.03)] compared to the single dose arm. Conclusions The 7 day MTZ dose was more effective than the single dose for the treatment of TV among HIV+ women. PMID:21423852

  14. Effects of 7-day continuous d-amphetamine, methylphenidate, and cocaine treatment on choice between methamphetamine and food in male rhesus monkeys*

    PubMed Central

    Schwienteck, Kathryn L.; Banks, Matthew L.

    2015-01-01

    Background Methamphetamine addiction is a significant public health problem for which no Food and Drug Administration-approved pharmacotherapies exist. Preclinical drug vs. food choice procedures have been predictive of clinical medication efficacy in the treatment of opioid and cocaine addiction. Whether preclinical choice procedures are predictive of candidate medication effects for other abused drugs, such as methamphetamine, remains unclear. The present study aim was to determine continuous 7-day treatment effects with the monoamine releaser d-amphetamine and the monoamine uptake inhibitor methylphenidate on methamphetamine vs. food choice.In addition, 7-day cocaine treatment effects were also examined. Methods Behavior was maintained under a concurrent schedule of food delivery (1-g pellets, fixed-ratio 100 schedule) and methamphetamine injections (0-0.32 mg/kg/injection, fixed-ratio 10 schedule) in male rhesus monkeys (n=4). Methamphetamine choice dose-effect functions were determined daily before and during 7-day periods of continuous intravenous treatment with d-amphetamine (0.01-0.1 mg/kg/h), methylphenidate (0.032-0.32 mg/kg/h), or cocaine (0.1-0.32 mg/kg/h). Results During saline treatment, increasing methamphetamine doses resulted in a corresponding increase in methamphetamine vs. food choice. Continuous 7-day treatments with d-amphetamine, methylphenidate or cocaine did not significantly attenuate methamphetamine vs. food choice up to doses that decreased rates of operant responding. However, 0.1 mg/kg/h d-amphetamine did eliminate methamphetamine choice in two monkeys. Conclusions The present subchronic treatment resultssupport the utility of preclinical methamphetamine choice to evaluate candidate medications for methamphetamine addiction. Furthermore, these results confirm and extend previous results demonstrating differential pharmacological mechanisms between cocaine choice and methamphetamine choice. PMID:26361713

  15. Effects of 7-day continuous D-amphetamine, methylphenidate, and cocaine treatment on choice between methamphetamine and food in male rhesus monkeys.

    PubMed

    Schwienteck, Kathryn L; Banks, Matthew L

    2015-10-01

    Methamphetamine addiction is a significant public health problem for which no Food and Drug Administration-approved pharmacotherapies exist. Preclinical drug vs. food choice procedures have been predictive of clinical medication efficacy in the treatment of opioid and cocaine addiction. Whether preclinical choice procedures are predictive of candidate medication effects for other abused drugs, such as methamphetamine, remains unclear. The present study aim was to determine continuous 7-day treatment effects with the monoamine releaser d-amphetamine and the monoamine uptake inhibitor methylphenidate on methamphetamine vs. food choice. In addition, 7-day cocaine treatment effects were also examined. Behavior was maintained under a concurrent schedule of food delivery (1-g pellets, fixed-ratio 100 schedule) and methamphetamine injections (0-0.32mg/kg/injection, fixed-ratio 10 schedule) in male rhesus monkeys (n=4). Methamphetamine choice dose-effect functions were determined daily before and during 7-day periods of continuous intravenous treatment with d-amphetamine (0.01-0.1mg/kg/h), methylphenidate (0.032-0.32mg/kg/h), or cocaine (0.1-0.32mg/kg/h). During saline treatment, increasing methamphetamine doses resulted in a corresponding increase in methamphetamine vs. food choice. Continuous 7-day treatments with d-amphetamine, methylphenidate or cocaine did not significantly attenuate methamphetamine vs. food choice up to doses that decreased rates of operant responding. However, 0.1mg/kg/h d-amphetamine did eliminate methamphetamine choice in two monkeys. The present subchronic treatment results support the utility of preclinical methamphetamine choice to evaluate candidate medications for methamphetamine addiction. Furthermore, these results confirm and extend previous results demonstrating differential pharmacological mechanisms between cocaine choice and methamphetamine choice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Iloprost drug delivery during infant conventional and high-frequency oscillatory ventilation

    PubMed Central

    DiBlasi, Robert M.; Crotwell, Dave N.; Shen, Shuijie; Zheng, Jiang; Fink, James B.; Yung, Delphine

    2016-01-01

    Abstract Iloprost is a selective pulmonary vasodilator approved for inhalation by the Food and Drug Administration. Iloprost has been increasingly used in the management of critically ill neonates with hypoxic lung disease. This in vitro study was designed to test the hypothesis that aerosol drug delivery could be effectively administered to infants with both conventional ventilation and high-frequency oscillatory ventilation (HFOV). A neonatal test lung model configured with newborn lung mechanics was ventilated with a conventional ventilator and an HFOV with standard settings. A vibrating-mesh nebulizer was placed (1) proximal to the patient airway in the inspiratory limb between the humidifier probe and patient wye (conventional) as well as between the vent circuit and the endotracheal tube (ETT) for HFOV and (2) between the ventilator and humidifier (distal). Iloprost was nebulized in three separate runs using three new nebulizers in each of the circuit locations. A collecting filter was placed at the distal end of the ETT for each trial. Iloprost was quantified using high-performance liquid chromatography. The percentage of nominal dose delivered was greater with the nebulizer placed proximal to the airway for conventional ventilation (10.74% ± 2%) and HFOV (29% ± 2%) than with it placed in the distal position (2.96% ± 0.2% vs. 0.96% ± 0.8%, respectively; P < 0.05). Drug delivery in proximal position was nearly threefold greater during HFOV than during conventional ventilation. In conclusion, iloprost drug delivery was best achieved when the nebulizer was placed proximal to the patient airway during neonatal mechanical ventilation. Drug delivery appears to be more efficient during HFOV than during conventional ventilation. PMID:27162615

  17. Ventilator-induced diaphragmatic dysfunction.

    PubMed

    Petrof, Basil J; Jaber, Samir; Matecki, Stefan

    2010-02-01

    Diaphragmatic function is a major determinant of the ability to successfully wean patients from mechanical ventilation. There is increasing recognition of a condition termed ventilator-induced diaphragmatic dysfunction. The purpose of the present review is to present evidence that mechanical ventilation can itself be a cause of diaphragmatic dysfunction, to outline our current understanding of the cellular mechanisms responsible for this phenomenon, and to discuss the implications of recent research for future therapeutic strategies. Many critically ill patients demonstrate diaphragmatic weakness. A large body of evidence from animal models, and more limited data from humans, indicates that mechanical ventilation can cause muscle fiber injury and atrophy within the diaphragm. Current data support a complex underlying pathophysiology involving oxidative stress and the activation of several intracellular proteolytic pathways involved in degradation of the contractile apparatus. This includes the calpain, caspase, and ubiquitin-proteasome systems. In addition, there is a simultaneous downregulation of protein synthesis pathways. Studies in animal models suggest that future therapies may be able to specifically target these processes, whereas for the time being current preventive measures in humans are primarily based upon allowing persistent diaphragmatic activation during mechanical ventilation. Diaphragmatic dysfunction is common in mechanically ventilated patients and is a likely cause of weaning failure. Recently, there has been a great expansion in our knowledge of how mechanical ventilation can adversely affect diaphragmatic structure and function. Future studies need to better define the evolution and mechanistic basis for ventilator-induced diaphragmatic dysfunction in humans, in order to allow the development of mechanical ventilation strategies and pharmacologic agents that will decrease the incidence of ventilator-induced diaphragmatic dysfunction.

  18. Solenoid-Simulation Circuit

    NASA Technical Reports Server (NTRS)

    Simon, R. A.

    1986-01-01

    Electrical properties of solenoids imitated for tests of control circuits. Simulation circuit imitates voltage and current responses of two engine-controlling solenoids. Used in tests of programs of digital engine-control circuits, also provides electronic interface with circuits imitating electrical properties of pressure sensors and linear variable-differential transformers. Produces voltages, currents, delays, and discrete turnon and turnoff signals representing operation of solenoid in engine-control relay. Many such circuits used simulating overall engine circuitry.

  19. A cross-over study comparing an online versus a paper 7-day food record: focus on total water intake data and participant's perception of the records.

    PubMed

    Monnerie, B; Tavoularis, L G; Guelinckx, I; Hebel, P; Boisvieux, T; Cousin, A; Le Bellego, L

    2015-06-01

    To compare (1) fluid, food and nutrient intake obtained with a paper versus an online version of a 7-day food record and (2) user's acceptability of both versions of the food record. A cross-over study was carried out in 2010 in France. A total of 246 participants aged 18-60 years reported their food and fluid intake using both versions of the 7-day food record, separated by a 7- to 14-day washout period. To help participants in estimating consumed portions, both versions of the food record were supported by a photographic booklet of standard portions and containers. At the end of the study protocol, participants completed a questionnaire designed to assess the acceptability of the two questionnaires. The reported water intake of fluids was significantly higher with the online version compared with the paper version (respectively 1348 ± 36 and 1219 ± 34 mL/day, p < 0.0001). No difference was found between methods in terms of energy intake and the consumption of most food categories, macro- and micronutrients. Furthermore, 77 % of the participants preferred the online method to the paper version. Fluid intake, but not food intake, reported with the online 7-day food record was higher in comparison with the paper version. In addition, the online version was preferred by users. In population surveys, the online record is therefore a relevant alternative, and even a preferred alternative in the case of fluid intake, to the paper record.

  20. Ventilation and respiratory mechanics.

    PubMed

    Sheel, Andrew William; Romer, Lee M

    2012-04-01

    During dynamic exercise, the healthy pulmonary system faces several major challenges, including decreases in mixed venous oxygen content and increases in mixed venous carbon dioxide. As such, the ventilatory demand is increased, while the rising cardiac output means that blood will have considerably less time in the pulmonary capillaries to accomplish gas exchange. Blood gas homeostasis must be accomplished by precise regulation of alveolar ventilation via medullary neural networks and sensory reflex mechanisms. It is equally important that cardiovascular and pulmonary system responses to exercise be precisely matched to the increase in metabolic requirements, and that the substantial gas transport needs of both respiratory and locomotor muscles be considered. Our article addresses each of these topics with emphasis on the healthy, young adult exercising in normoxia. We review recent evidence concerning how exercise hyperpnea influences sympathetic vasoconstrictor outflow and the effect this might have on the ability to perform muscular work. We also review sex-based differences in lung mechanics.

  1. Solar ventilation and tempering

    NASA Astrophysics Data System (ADS)

    Adámek, Karel; Pavlů, Miloš; Bandouch, Milan

    2014-08-01

    The paper presents basic information about solar panels, designed, realized and used for solar ventilation of rooms. Used method of numerical flow simulation gives good overview about warming and flowing of the air in several kinds of realized panels (window, facade, chimney). Yearlong measurements give a good base for calculations of economic return of invested capital. The operation of the system in transient period (spring, autumn) prolongs the period without classical heating of the room or building, in winter the classical heating is supported. In the summer period the system, furnished with chimney, can exhaust inner warm air together with necessary cooling of the system by gravity circulation, only. System needs not any invoiced energy source; it is supplied entirely by solar energy. Large building systems are supported by classical electric fan respectively.

  2. Cardiac gated ventilation

    SciTech Connect

    Hanson, C.W. III; Hoffman, E.A.

    1995-12-31

    There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart.

  3. Contributing Factors for Morbidity and Mortality in Patients with Organophosphate Poisoning on Mechanical Ventilation: A Retrospective Study in a Teaching Hospital

    PubMed Central

    Patil, Gurulingappa; Nikhil, M.

    2016-01-01

    Introduction One of the most common causes of poisoning in agricultural based developing countries like India is due to Organophosphorus (OP) compound. Its widespread use and easy availability has increased the likelihood of poisoning with these compounds. Aim To study the morbidity and mortality in patients with acute OP poisoning requiring mechanical ventilation. Materials and Methods This was a retrospective study constituting patients of all age groups admitted to the Intensive Care Unit (ICU) with diagnosis of OP poisoning between January 2015 to December 2015. Of 66 OP poisoning cases those patients who went against medical advice, 20 were excluded from the study and thus 46 patients were included. Diagnosis was performed from the history taken either from the patient or from the patient’s relatives and presenting symptoms. Demographic data, month of the year, age of patient, mode of poisoning, cholinesterase levels, duration of mechanical ventilation and mortality were recorded. Data are presented as mean±SD. Results A 97.83% (45/46) of cases were suicidal. Out of 46, 9 were intubated and mechanically ventilated. Duration of mechanical ventilation varied from less than 48 hours to more than 7 days. Mortality rate was 50%, 0% and 100% in those who required mechanical ventilation for more than 7 days, 2 to 7 days and <2days respectively. None of the predictors like age, severity of poisoning, cholinesterase levels and duration of ventilation were independent predictors of death and all of them contributed to the mortality. Overall mortality rate in those who required mechanical ventilation was 22.22%. Conclusion Morbidity and mortality due to OP poisoning is directly proportional to the age, severity of poisoning and duration of mechanical ventilation and inversely proportional to serum cholinesterase level. PMID:28208980

  4. Fertility in Angus cross beef cows following 5-day CO-Synch + CIDR or 7-day CO-Synch + CIDR estrus synchronization and timed artificial insemination.

    PubMed

    Whittier, William D; Currin, John F; Schramm, Holly; Holland, Sarah; Kasimanickam, Ramanathan K

    2013-12-01

    The present study determined whether a 5-day CO-Synch + controlled internal drug release (CIDR) protocol with two doses of PGF2α would improve timed artificial insemination (AI) pregnancy rate compared with 7-day CO-Synch + CIDR protocol in beef cows. Angus cross beef cows (N = 1817) at 12 locations were randomly assigned to 5-day CO-Synch + CIDR or 7-day CO-Synch + CIDR groups. All cows received 100 μg of GnRH and a CIDR insert on Day 0. Cows (n = 911) in the 5-day CO-Synch + CIDR group received two doses of 25 mg PGF, the first dose given on Day 5 at CIDR removal and the second dose 6 hours later, and 100 μg GnRH on Day 8 and were inseminated concurrently, 72 hours after CIDR removal. Cows (n = 906) in 7-day CO-Synch + CIDR group received 25 mg of PGF at CIDR removal on Day 7, and 100 μg GnRH on Day 10 and were inseminated concurrently, 66 to 72 hours after CIDR removal. All cows were fitted with a heat detector aid at CIDR removal and were observed twice daily until insemination for estrus and heat detector aid status. Accounting for estrus expression at or before AI (P < 0.0001) and body condition score (P < 0.01), cows in the 5-day CO-Synch + CIDR group had greater AI pregnancy rate compared with cows in the 7-day CO-Synch + CIDR group (58.1% vs. 55.1%; P = 0.04). More cows that exhibited estrus at or before AI became pregnant compared with cows that did not [65.7% (681/1037) vs. 44.5% (347/780); P < 0.0001]. The AI pregnancy rate was lesser for cows with body condition ≤4 [≤4 - 49.3% (101/219), 5-6 - 57.9%; >6 - 55.8%]. The mean AI pregnancy rate difference between treatment groups and projected economic outcome varied among locations. In conclusion, cows synchronized with the 5-day CO-Synch + CIDR protocol had greater AI pregnancy rate than those that received the 7-day CO-Synch + CIDR protocol. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Estimation of Lung Ventilation

    NASA Astrophysics Data System (ADS)

    Ding, Kai; Cao, Kunlin; Du, Kaifang; Amelon, Ryan; Christensen, Gary E.; Raghavan, Madhavan; Reinhardt, Joseph M.

    Since the primary function of the lung is gas exchange, ventilation can be interpreted as an index of lung function in addition to perfusion. Injury and disease processes can alter lung function on a global and/or a local level. MDCT can be used to acquire multiple static breath-hold CT images of the lung taken at different lung volumes, or with proper respiratory control, 4DCT images of the lung reconstructed at different respiratory phases. Image registration can be applied to this data to estimate a deformation field that transforms the lung from one volume configuration to the other. This deformation field can be analyzed to estimate local lung tissue expansion, calculate voxel-by-voxel intensity change, and make biomechanical measurements. The physiologic significance of the registration-based measures of respiratory function can be established by comparing to more conventional measurements, such as nuclear medicine or contrast wash-in/wash-out studies with CT or MR. An important emerging application of these methods is the detection of pulmonary function change in subjects undergoing radiation therapy (RT) for lung cancer. During RT, treatment is commonly limited to sub-therapeutic doses due to unintended toxicity to normal lung tissue. Measurement of pulmonary function may be useful as a planning tool during RT planning, may be useful for tracking the progression of toxicity to nearby normal tissue during RT, and can be used to evaluate the effectiveness of a treatment post-therapy. This chapter reviews the basic measures to estimate regional ventilation from image registration of CT images, the comparison of them to the existing golden standard and the application in radiation therapy.

  6. Effect of outside air ventilation rate on volatile organic compound concentrations in a call center

    NASA Astrophysics Data System (ADS)

    Hodgson, A. T.; Faulkner, D.; Sullivan, D. P.; DiBartolomeo, D. L.; Russell, M. L.; Fisk, W. J.

    A study of the relationship between outside air ventilation rate and concentrations of volatile organic compounds (VOCs) generated indoors was conducted in a call center office building. The building, with two floors and a total floor area of 4600 m 2, is located in the San Francisco Bay Area, CA. Ventilation rates were manipulated with the building's four air handling units (AHUs). VOC and CO 2 concentrations in the AHU returns were measured on 7 days during a 13-week period. VOC emission factors were determined for individual zones on days when they were operating at near steady-state conditions. The emission factor data were subjected to principal component (PC) analysis to identify groups of co-varying compounds. Potential sources of the PC vectors were ascribed based on information from the literature. The per occupant CO 2 generation rates were 0.0068-0.0092 l s -1. The per occupant isoprene generation rates of 0.2-0.3 mg h -1 were consistent with the value predicted by mass balance from breath concentration and exhalation rate. The relationships between indoor minus outdoor VOC concentrations and ventilation rate were qualitatively examined for eight VOCs. Of these, acetaldehyde and hexanal, which likely were associated with material sources, and decamethylcyclopentasiloxane, associated with personal care products, exhibited general trends of higher concentrations at lower ventilation rates. For other compounds, a clear inverse relationship between VOC concentrations and ventilation was not observed. The net concentration of 2,2,4-trimethyl-1,3-pentanediol monoisobutyrate isomers, examples of low-volatility compounds, changed very little with ventilation likely due to sorption and re-emission effects. These results illustrate that the efficacy of ventilation for controlling VOC concentrations can vary considerably depending upon the operation of the building, the pollutant sources and the physical and chemical processes affecting the pollutants. Thus, source

  7. Ventilator Associated Pneumonia in Children.

    PubMed

    Chang, Ivy; Schibler, Andreas

    2016-09-01

    Ventilator associated pneumonia (VAP) is a common complication in mechanically ventilated children and adults. There remains much controversy in the literature over the definition, treatment and prevention of VAP. The incidence of VAP is variable, depending on the definition used and can effect up to 12% of ventilated children. For the prevention and reduction of the incidence of VAP, ventilation care bundles are suggested, which include vigorous hand hygiene, head elevation and use of non-invasive ventilation strategies. Diagnosis is mainly based on the clinical presentation with a lung infection occurring after 48hours of mechanical ventilation requiring a change in ventilator settings (mainly increased oxygen requirement, a positive culture of a specimen taken preferentially using a sterile sampling technique either using a bronchoscope or a blind lavage of the airways). A new infiltrate on a chest X ray supports the diagnosis of VAP. For the treatment of VAP, initial broad-spectrum antibiotics should be used followed by a specific antibiotic therapy with a narrow target once the bacterium is confirmed.

  8. Hidden circuits and argumentation

    NASA Astrophysics Data System (ADS)

    Leinonen, Risto; Kesonen, Mikko H. P.; Hirvonen, Pekka E.

    2016-11-01

    Despite the relevance of DC circuits in everyday life and schools, they have been shown to cause numerous learning difficulties at various school levels. In the course of this article, we present a flexible method for teaching DC circuits at lower secondary level. The method is labelled as hidden circuits, and the essential idea underlying hidden circuits is in hiding the actual wiring of DC circuits, but to make their behaviour evident for pupils. Pupils are expected to find out the wiring of the circuit which should enhance their learning of DC circuits. We present two possible ways to utilise hidden circuits in a classroom. First, they can be used to test and enhance pupils’ conceptual understanding when pupils are expected to find out which one of the offered circuit diagram options corresponds to the actual circuit shown. This method aims to get pupils to evaluate the circuits holistically rather than locally, and as a part of that aim this method highlights any learning difficulties of pupils. Second, hidden circuits can be used to enhance pupils’ argumentation skills with the aid of argumentation sheet that illustrates the main elements of an argument. Based on the findings from our co-operating teachers and our own experiences, hidden circuits offer a flexible and motivating way to supplement teaching of DC circuits.

  9. Subsurface Ventilation System Description Document

    SciTech Connect

    Eric Loros

    2001-07-25

    The Subsurface Ventilation System supports the construction and operation of the subsurface repository by providing air for personnel and equipment and temperature control for the underground areas. Although the system is located underground, some equipment and features may be housed or located above ground. The system ventilates the underground by providing ambient air from the surface throughout the subsurface development and emplacement areas. The system provides fresh air for a safe work environment and supports potential retrieval operations by ventilating and cooling emplacement drifts. The system maintains compliance within the limits established for approved air quality standards. The system maintains separate ventilation between the development and waste emplacement areas. The system shall remove a portion of the heat generated by the waste packages during preclosure to support thermal goals. The system provides temperature control by reducing drift temperature to support potential retrieval operations. The ventilation system has the capability to ventilate selected drifts during emplacement and retrieval operations. The Subsurface Facility System is the main interface with the Subsurface Ventilation System. The location of the ducting, seals, filters, fans, emplacement doors, regulators, and electronic controls are within the envelope created by the Ground Control System in the Subsurface Facility System. The Subsurface Ventilation System also interfaces with the Subsurface Electrical System for power, the Monitored Geologic Repository Operations Monitoring and Control System to ensure proper and safe operation, the Safeguards and Security System for access to the emplacement drifts, the Subsurface Fire Protection System for fire safety, the Emplacement Drift System for repository performance, and the Backfill Emplacement and Subsurface Excavation Systems to support ventilation needs.

  10. Subsurface Ventilation System Description Document

    SciTech Connect

    2000-10-12

    The Subsurface Ventilation System supports the construction and operation of the subsurface repository by providing air for personnel and equipment and temperature control for the underground areas. Although the system is located underground, some equipment and features may be housed or located above ground. The system ventilates the underground by providing ambient air from the surface throughout the subsurface development and emplacement areas. The system provides fresh air for a safe work environment and supports potential retrieval operations by ventilating and cooling emplacement drifts. The system maintains compliance within the limits established for approved air quality standards. The system maintains separate ventilation between the development and waste emplacement areas. The system shall remove a portion of the heat generated by the waste packages during preclosure to support thermal goals. The system provides temperature control by reducing drift temperature to support potential retrieval operations. The ventilation system has the capability to ventilate selected drifts during emplacement and retrieval operations. The Subsurface Facility System is the main interface with the Subsurface Ventilation System. The location of the ducting, seals, filters, fans, emplacement doors, regulators, and electronic controls are within the envelope created by the Ground Control System in the Subsurface Facility System. The Subsurface Ventilation System also interfaces with the Subsurface Electrical System for power, the Monitored Geologic Repository Operations Monitoring and Control System to ensure proper and safe operation, the Safeguards and Security System for access to the emplacement drifts, the Subsurface Fire Protection System for fire safety, the Emplacement Drift System for repository performance, and the Backfill Emplacement and Subsurface Excavation Systems to support ventilation needs.

  11. Adhesion of volatile propofol to breathing circuit tubing.

    PubMed

    Lorenz, Dominik; Maurer, Felix; Trautner, Katharina; Fink, Tobias; Hüppe, Tobias; Sessler, Daniel I; Baumbach, Jörg Ingo; Volk, Thomas; Kreuer, Sascha

    2017-08-21

    Propofol in exhaled breath can be measured and may provide a real-time estimate of plasma concentration. However, propofol is absorbed in plastic tubing, thus estimates may fail to reflect lung/blood concentration if expired gas is not extracted directly from the endotracheal tube. We evaluated exhaled propofol in five ventilated ICU patients who were sedated with propofol. Exhaled propofol was measured once per minute using ion mobility spectrometry. Exhaled air was sampled directly from the endotracheal tube and at the ventilator end of the expiratory side of the anesthetic circuit. The circuit was disconnected from the patient and propofol was washed out with a separate clean ventilator. Propofol molecules, which discharged from the expiratory portion of the breathing circuit, were measured for up to 60 h. We also determined whether propofol passes through the plastic of breathing circuits. A total of 984 data pairs (presented as median values, with 95% confidence interval), consisting of both concentrations were collected. The concentration of propofol sampled near the patient was always substantially higher, at 10.4 [10.25-10.55] versus 5.73 [5.66-5.88] ppb (p < 0.001). The reduction in concentration over the breathing circuit tubing was 4.58 [4.48-4.68] ppb, 3.46 [3.21-3.73] in the first hour, 4.05 [3.77-4.34] in the second hour, and 4.01 [3.36-4.40] in the third hour. Out-gassing propofol from the breathing circuit remained at 2.8 ppb after 60 h of washing out. Diffusion through the plastic was not observed. Volatile propofol binds or adsorbs to the plastic of a breathing circuit with saturation kinetics. The bond is reversible so propofol can be washed out from the plastic. Our data confirm earlier findings that accurate measurements of volatile propofol require exhaled air to be sampled as close as possible to the patient.

  12. Liquid ventilation: a future modality?

    PubMed

    Bresnahan, M

    1999-09-01

    Liquid ventilation, an idea currently being trialled in the United States, is increasingly being discussed as a possible future trend in ventilation. A review of the available literature indicates that this treatment provides effective gas exchange and has a number of potential advantages. These include lower airway pressures, decreased alveolar surface tension, alveolar recruitment and removal of pulmonary exudate. While yet to be seen in this country, liquid ventilation may be introduced in the future. If it is, those caring for patients treated in that way will require knowledge of the mechanics and physiological changes involved, as well as the potential hazards of this modality.

  13. Comparison of Tidal Volumes at the Endotracheal Tube and at the Ventilator.

    PubMed

    Kim, Paul; Salazar, Adler; Ross, Patrick A; Newth, Christopher J L; Khemani, Robinder G

    2015-11-01

    Lung protective ventilation for children with acute respiratory distress syndrome requires accurate assessment of tidal volume. Although modern ventilators compensate for ventilator tubing compliance, tidal volume measured at the ventilator may not be accurate, particularly in small children. Although ventilator-specific proximal flow sensors that measure tidal volume at the endotracheal tube have been developed, there is little information regarding their accuracy. We sought to test the accuracy of ventilator measured tidal volume with and without proximal flow sensors against a calibrated pneumotachometer in children. Prospective, observational. Tertiary care PICU. Fifty-one endotracheally intubated and mechanically ventilated children younger than 18 years. Tidal volumes were measured at the ventilator, using a ventilator-specific flow sensor, and a calibrated pneumotachometer connected to the SensorMedics 2600A Pediatric Pulmonary Function Cart. In a pressure control mode of ventilation: median tidal volume measured with the pneumotachometer (9.5 mL/kg [interquartile range, 8.2-11.7 mL/kg]) was significantly higher than tidal volume measured either at the ventilator (8.2 mL/kg [7.1-9.6 mL/kg]) or at the proximal flow sensor (8.1 mL/kg [7.2-10.0 mL/kg]) (p < 0.001). In pressure regulated volume control mode of ventilation: median tidal volume measured with the pneumotachometer (10.2 mL/kg [8.8-12.4 mL/kg]) was significantly higher than tidal volume measured either at the ventilator (8.0 mL/kg [7.1-9.7 mL/kg]) or at the proximal flow sensor (8.5 mL/kg [7.3-10.4 mL/kg]) (p < 0.001). These findings were consistent when subgrouped by ventilator type and circuit size. Tidal volume measured either at the endotracheal tube with a proximal flow sensor or at the ventilator with compensation for tubing compliance are both significantly lower than tidal volume measured with a calibrated pneumotachometer. This underestimation of delivered tidal volume may be particularly

  14. 6. VIEW LOOKING SOUTHEAST AT VENTILATION EQUIPMENT IN SOUTH VENTILATION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. VIEW LOOKING SOUTHEAST AT VENTILATION EQUIPMENT IN SOUTH VENTILATION HOUSE. THIS AIR CONDITIONING SYSTEM WAS INSTALLED BY PARKS-CRAMER COMPANY OF FITCHBURG, MASSACHUSETTS WHEN THE MILL WAS CONSTRUCTED IN 1923-24. ONE AIR WASHER AND FAN ROOM EXTERIOR IS VISIBLE ON THE RIGHT. THE DUCTS FROM BOTH FAN ROOMS (CURVED METAL STRUCTURES AT CENTER AND LEFT OF PHOTO) ARE CONNECTED TO A COMMON AIR SHAFT. - Stark Mill, 117 Corinth Road, Hogansville, Troup County, GA

  15. The use of chilled condensers for the recovery of perfluorocarbon liquid in an experimental model of perfluorocarbon vapour loss during neonatal partial liquid ventilation

    PubMed Central

    Dunster, Kimble R; Davies, Mark W; Fraser, John F

    2007-01-01

    Background Perfluorocarbon (PFC) vapour in the expired gases during partial liquid ventilation should be prevented from entering the atmosphere and recovered for potential reuse. This study aimed to determine how much PFC liquid could be recovered using a conventional humidified neonatal ventilator with chilled condensers in place of the usual expiratory ventilator circuit and whether PFC liquid could be recovered when using the chilled condensers at the ventilator exhaust outlet. Methods Using a model lung, perfluorocarbon vapour loss during humidified partial liquid ventilation of a 3.5 kg infant was approximated. For each test 30 mL of FC-77 was infused into the model lung. Condensers were placed in the expiratory limb of the ventilator circuit and the amounts of PFC (FC-77) and water recovered were measured five times. This was repeated with the condensers placed at the ventilator exhaust outlet. Results When the condensers were used as the expiratory limb, the mean (± SD) volume of FC77 recovered was 16.4 mL (± 0.18 mL). When the condensers were connected to the ventilator exhaust outlet the mean (± SD) volume of FC-77 recovered was 7.6 mL (± 1.14 mL). The volume of FC-77 recovered was significantly higher when the condenser was used as an expiratory limb. Conclusion Using two series connected condensers in the ventilator expiratory line 55% of PFC liquid (FC-77) can be recovered during partial liquid ventilation without altering the function of the of the ventilator circuit. This volume of PFC recovered was just over twice that recovered with the condensers connected to the ventilator exhaust outlet. PMID:17537270

  16. Preoperational test report, vent building ventilation system

    SciTech Connect

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  17. 30 CFR 57.8520 - Ventilation plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Ventilation plan. 57.8520 Section 57.8520... SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Ventilation Underground Only § 57.8520 Ventilation plan. A plan of the mine ventilation system shall be set out by...

  18. 24 CFR 3285.505 - Crawlspace ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Crawlspace ventilation. 3285.505... ventilation. (a) A crawlspace with skirting must be provided with ventilation openings. The minimum net area of ventilation openings must not be less than one square foot (ft.2) for every 150 square feet...

  19. 24 CFR 3285.505 - Crawlspace ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Crawlspace ventilation. 3285.505... ventilation. (a) A crawlspace with skirting must be provided with ventilation openings. The minimum net area of ventilation openings must not be less than one square foot (ft.2) for every 150 square feet...

  20. 30 CFR 57.8520 - Ventilation plan.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Ventilation plan. 57.8520 Section 57.8520... Underground Only § 57.8520 Ventilation plan. A plan of the mine ventilation system shall be set out by the... ventilation plan or revisions thereto shall be submitted to the District Manager for review and comments...

  1. 30 CFR 57.8520 - Ventilation plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Ventilation plan. 57.8520 Section 57.8520... Underground Only § 57.8520 Ventilation plan. A plan of the mine ventilation system shall be set out by the... ventilation plan or revisions thereto shall be submitted to the District Manager for review and comments...

  2. Preoperational test, vent building ventilation system

    SciTech Connect

    Clifton, F.T., Westinghouse Hanford

    1996-08-20

    Preoperational Test Procedure for Vent Building Ventilation System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The Vent Building ventilation system provides ventilation, heating, cooling, and zone confinement control for the W-030 Project Vent Building. The tests verify correct System operation and correct indications displayed by the central Monitor and Control system.

  3. 46 CFR 168.15-50 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Ventilation. 168.15-50 Section 168.15-50 Shipping COAST... Accommodations § 168.15-50 Ventilation. (a) All quarters must be adequately ventilated in a manner suitable to the purpose of the space and route of the vessel. (b) When mechanical ventilation is provided...

  4. 46 CFR 194.20-5 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Ventilation. 194.20-5 Section 194.20-5 Shipping COAST... Ventilation. (a) Chemical storerooms shall be equipped with a power ventilation system of exhaust type. The... based upon the volume of the compartment. (1) Power ventilation units shall have nonsparking...

  5. 33 CFR 175.201 - Ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Ventilation. 175.201 Section 175... SAFETY EQUIPMENT REQUIREMENTS Ventilation § 175.201 Ventilation. No person may operate a boat built after... unless it is equipped with an operable ventilation system that meets the requirements of 33 CFR...

  6. 33 CFR 175.201 - Ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Ventilation. 175.201 Section 175... SAFETY EQUIPMENT REQUIREMENTS Ventilation § 175.201 Ventilation. No person may operate a boat built after... unless it is equipped with an operable ventilation system that meets the requirements of 33 CFR...

  7. 24 CFR 3285.505 - Crawlspace ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 5 2013-04-01 2013-04-01 false Crawlspace ventilation. 3285.505... ventilation. (a) A crawlspace with skirting must be provided with ventilation openings. The minimum net area of ventilation openings must not be less than one square foot (ft.2) for every 150 square feet...

  8. 33 CFR 175.201 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Ventilation. 175.201 Section 175... SAFETY EQUIPMENT REQUIREMENTS Ventilation § 175.201 Ventilation. No person may operate a boat built after... unless it is equipped with an operable ventilation system that meets the requirements of 33 CFR...

  9. 46 CFR 168.15-50 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Ventilation. 168.15-50 Section 168.15-50 Shipping COAST... Accommodations § 168.15-50 Ventilation. (a) All quarters must be adequately ventilated in a manner suitable to the purpose of the space and route of the vessel. (b) When mechanical ventilation is provided...

  10. 46 CFR 194.20-5 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Ventilation. 194.20-5 Section 194.20-5 Shipping COAST... Ventilation. (a) Chemical storerooms shall be equipped with a power ventilation system of exhaust type. The... based upon the volume of the compartment. (1) Power ventilation units shall have nonsparking...

  11. 46 CFR 168.15-50 - Ventilation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Accommodations § 168.15-50 Ventilation. (a) All quarters must be adequately ventilated in a manner suitable to the purpose of the space and route of the vessel. (b) When mechanical ventilation is provided for... 46 Shipping 7 2010-10-01 2010-10-01 false Ventilation. 168.15-50 Section 168.15-50 Shipping...

  12. New operational technology of intrauterine ventilation the fetus lungs by breathing gas

    NASA Astrophysics Data System (ADS)

    Urakov, A. L.; Nikityuk, D. B.; Urakova, N. A.; Kasankin, A. A.; Chernova, L. V.; Dementiev, V. B.

    2015-11-01

    New operational technology for elimination intrauterine hypoxia and asphyxia of the fetus using endoscopic artificial ventilation lungs by respiratory gas was developed. For intrauterine ventilation of fetal lung it is proposed to enter into the uterus a special breathing mask and wear it on the head of the fetus using the original endoscopic technology. The breathing mask, developed by us is connected with external breathing apparatus with a hose. The device is called "intrauterine aqualung". Intrauterine aqualung includes a ventilator and breathing circuit with a special fold-out breathing mask that is put on inside the uterus on the head of fetus like a mesh hat. Controlled by ultrasound the technology of the introduction of the mask inside of the uterus through the natural opening in the cervix and technology of putting on the respiratory mask on the head of the fetus with its head previa were developed. The technology intrauterine ventilation of the fetus lungs by respiratory gas was developed.

  13. 46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Power ventilation systems except machinery space ventilation systems. Each power ventilation system...

  14. 46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Power ventilation systems except machinery space ventilation systems. Each power ventilation system...

  15. Equivalence in Ventilation and Indoor Air Quality

    SciTech Connect

    Sherman, Max; Walker, Iain; Logue, Jennifer

    2011-08-01

    We ventilate buildings to provide acceptable indoor air quality (IAQ). Ventilation standards (such as American Society of Heating, Refrigerating, and Air-Conditioning Enginners [ASHRAE] Standard 62) specify minimum ventilation rates without taking into account the impact of those rates on IAQ. Innovative ventilation management is often a desirable element of reducing energy consumption or improving IAQ or comfort. Variable ventilation is one innovative strategy. To use variable ventilation in a way that meets standards, it is necessary to have a method for determining equivalence in terms of either ventilation or indoor air quality. This study develops methods to calculate either equivalent ventilation or equivalent IAQ. We demonstrate that equivalent ventilation can be used as the basis for dynamic ventilation control, reducing peak load and infiltration of outdoor contaminants. We also show that equivalent IAQ could allow some contaminants to exceed current standards if other contaminants are more stringently controlled.

  16. Detection of carcinoembryonic antigen messenger RNA-expressing cells in peripheral blood 7 days after curative surgery is a novel prognostic factor in colorectal cancer.

    PubMed

    Sadahiro, Sotaro; Suzuki, Toshiyuki; Maeda, Yuji; Yurimoto, Satoshi; Yasuda, Seiei; Makuuchi, Hiroyasu; Kamijo, Akemi; Murayama, Chieko

    2007-03-01

    The significance of detection of circulating cancer cells in blood during surgery in patients with colorectal cancer (CRC) remains controversial. Experimental study revealed that the cancer cells injected from the vein disappeared completely until 7 days. The aim of this study was to clarify that the detection of circulating cancer cells in blood taken later than 7 days after curative surgery may be a prognostic factor. Two hundred consecutive patients with CRC who underwent potentially curative surgery were the subjects. Peripheral blood was collected between 7 and 10 days after resection. Cancer cells were detected using reverse transcriptase-polymerase chain reaction targeting carcinoembryonic antigen (CEA) messenger RNA (mRNA). The median follow-up period was 52 months (range: 34-69 months). The overall positive incidence of CEA mRNA was 22%. Detection of CEA mRNA was not significantly related to conventional clinicopathological findings. Recurrence has been confirmed in 55 patients (28%). The recurrence rate was significantly higher in patients with rectal cancer, deep penetration, lymph node metastasis, preoperative chemoradiotherapy and positive CEA mRNA. The CEA mRNA positive patients showed significantly poorer disease free survival (DFS) and overall survival (OS) than the negative patients (DFS, P = 0.007; OS, P = 0.04). Multivariate analysis revealed that the positive expression of CEA mRNA (P < 0.01) as well as the tumor location and TNM stage classification was identified as the significant risk factors for recurrence. Detection of CEA mRNA expressing cells in peripheral blood 7 days after curative surgery is a novel independent factor predicting recurrence in patients with CRC.

  17. Effect of variability in the 7-day baseline pain diary on the assay sensitivity of neuropathic pain randomized clinical trials: an ACTTION study.

    PubMed

    Farrar, John T; Troxel, Andrea B; Haynes, Kevin; Gilron, Ian; Kerns, Robert D; Katz, Nathaniel P; Rappaport, Bob A; Rowbotham, Michael C; Tierney, Ann M; Turk, Dennis C; Dworkin, Robert H

    2014-08-01

    The degree of variability in the patient baseline 7-day diary of pain ratings has been hypothesized to have a potential effect on the assay sensitivity of randomized clinical trials of pain therapies. To address this issue, we obtained clinical trial data from the Food and Drug Administration (FDA) through the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership, and harmonized patient level data from 12 clinical trials (4 gabapentin and 8 pregabalin) in postherpetic neuralgia (PHN) and painful diabetic peripheral neuropathy (DPN). Models were developed using exploratory logistic regression to examine the interaction between available baseline factors and treatment (placebo vs active medication) in predicting patient response to therapy (ie, >30% improvement). Our analysis demonstrated an increased likelihood of response in the placebo-treated group for patients with a higher standard deviation in the baseline 7-day diary without affecting the likelihood of a response in the active medication-treated group, confirming our hypothesis. In addition, there was a small but significant age-by-treatment interaction in the PHN model, and small weight-by-treatment interaction in the DPN model. The patient's sex, baseline pain level, and the study protocol had an effect only on the likelihood of response overall. Our results suggest the possibility that, at least in some disease processes, excluding patients with a highly variable baseline 7-day diary has the potential to improve the assay sensitivity of these analgesic clinical trials, although reductions of external validity must be considered when increasing the homogeneity of the investigated sample.

  18. A randomized, double-blind study comparing 5 days oral gemifloxacin with 7 days oral levofloxacin in patients with acute exacerbation of chronic bronchitis.

    PubMed

    Sethi, S; Fogarty, C; Fulambarker, A

    2004-08-01

    To demonstrate that 5 days of treatment with a new fluoroquinolone, gemifloxacin, is at least as effective as 7 days of treatment with levofloxacin in adult patients with acute exacerbation of chronic bronchitis (AECB). Randomized, double-blind, double dummy, multicentre, parallel group study Sixty different medical centers in US, UK and Germany. A total of 360 adults (>40 years of age) with AECB were randomly assigned to receive gemifloxacin 320 mg once daily for 5 days or levofloxacin 500mg once daily for 7 days. The primary efficacy parameter was a clinical response at follow-up (Days 14-21). In total, 335/360 patients completed the study (93.1%). Seven patients receiving gemifloxacin withdrew from the study compared to 18 patients receiving levofloxacin; this difference was statistically significant (Fisher's exact test: p=0.02). In the intent-to-treat (ITT) population, the clinical success rate at follow-up (Days 14-21) was 85.2% (155/182) with gemifloxacin and 78.1% (139/178) with levofloxacin. Clinical success rate in the per-protocol (PP) population was 88.2% (134/152) with gemifloxacin and 85.1% (126/148) with levofloxacin. At long-term follow-up (Days 28-35), the clinical success rates in the PP population were 83.7% (123/147) with gemifloxacin and 78.4% (109/139) with levofloxacin. The difference in success rates was 5.26% (95% CI: -3.83, 14.34). The clinical efficacy of gemifloxacin 320 mg once daily for 5 days in AECB was at least as good as levofloxacin 500 mg once daily for 7 days. Fewer withdrawals and superior clinical efficacy at long-term follow-up were also seen with gemifloxacin.

  19. Continuous accelerated 7-days-a-week radiotherapy for head-and-neck cancer: Long-term results of Phase III clinical trial

    SciTech Connect

    Skladowski, Krzysztof . E-mail: skladowski@io.gliwice.pl; Maciejewski, Boguslaw; Golen, Maria; Tarnawski, Rafal; Slosarek, Krzysztof; Suwinski, Rafal; Sygula, Mariusz; Wygoda, Andrzej

    2006-11-01

    Purpose: To update 5-year results of a previously published study on special 7-days-a-week fractionation continuous accelerated irradiation (CAIR) for head-and-neck cancer patients. Methods and Materials: One hundred patients with squamous cell carcinoma of head and neck in Stage T{sub 2-4}N{sub 0-1}M were randomized between two definitive radiation treatments: accelerated fractionation 7 days a week including weekends (CAIR) and conventional 5 days a week (control). Hence the overall treatment time was 2 weeks shorter in CAIR. Results: Five-year local tumor control was 75% in the CAIR group and 33% in the control arm (p < 0.00004). Tumor-cure benefit corresponded with significant improvement in disease-free survival and overall survival rates. Confluent mucositis was the main acute toxicity, with the incidence significantly higher in CAIR patients than in control (respectively, 94% vs. 53%). When 2.0-Gy fractions were used, radiation necrosis developed in 5 patients (22%) in the CAIR group as a consequential late effect (CLE), but when fraction size was reduced to 1.8 Gy no more CLE occurred. Actuarial 5-year morbidity-free survival rate was similar for both treatments. Conclusions: Selected head-and-neck cancer patients could be treated very effectively with 7-days-a-week radiation schedule with no compromise of total dose and with slight 10% reduction of fraction dose (2 Gy-1.8 Gy), which article gives 1 week reduction of overall treatment time compared with standard 70 Gy in 35 fractions over 47-49 days. Although this report is based on the relatively small group of patients, its results have encouraged us to use CAIR fractionation in a standard radiation treatment for moderately advanced head-and-neck cancer patients.

  20. Basic concepts in mechanical ventilation.

    PubMed

    Carbery, Catherine

    2008-03-01

    Mechanical ventilatory support is a major component of the clinical management of critically ill patients admitted into intensive care. Closely linked with the developments within critical care medicine, the use of ventilatory support has been increasing since the polio epidemics in the 1950s (Lassen 1953). Initially used to provide controlled mandatory ventilation, today with advances in technology, most mechanical ventilators are triggered by the patient, increasing the awareness of the complexity of patient/ventilator interaction (Tobin 1994). Though ventilator appearance and design may have changed quite significantly and the variety of options for support extensive, the basic concepts of mechanical ventilatory support of the critically ill patient remains unchanged. This paper aims to outline these concepts so as to gain a better understanding of mechanical ventilatory support.

  1. Mechanical ventilation in the home.

    PubMed

    Make, B J; Gilmartin, M E

    1990-07-01

    Despite advances in the application of mechanical ventilation as a short-term, life-saving technique, intensive care units are increasingly faced with patients who cannot be weaned from ventilatory assistance and who require mechanical ventilation as a long-term, life-supporting necessity. Because of limited resources in health care facilities for the management of chronic ventilator-assisted individuals, home care has become an important option. With careful selection of appropriate candidates, home care for ventilator-assisted individuals can result in not only decreased respiratory symptoms, reduction in hospitalization, and improved physiologic measures, but also an improved quality of life with substantial survival and a reduction in the costs of medical care.

  2. Electrical Circuits and Water Analogies

    ERIC Educational Resources Information Center

    Smith, Frederick A.; Wilson, Jerry D.

    1974-01-01

    Briefly describes water analogies for electrical circuits and presents plans for the construction of apparatus to demonstrate these analogies. Demonstrations include series circuits, parallel circuits, and capacitors. (GS)

  3. Electrical Circuits and Water Analogies

    ERIC Educational Resources Information Center

    Smith, Frederick A.; Wilson, Jerry D.

    1974-01-01

    Briefly describes water analogies for electrical circuits and presents plans for the construction of apparatus to demonstrate these analogies. Demonstrations include series circuits, parallel circuits, and capacitors. (GS)

  4. [Status of the lipid peroxidation system in the tissues of rats following a 7-day flight on the Kosmos-1667 biosatellite].

    PubMed

    Delenian, N V; Markin, A A

    1989-01-01

    Rats flown for 7 days on Cosmos-1667 were for the first time used to measure antioxidative enzymes (superoxide dismutase, glutathione peroxidase, glutathione reductase, catalase), lipid peroxidation products (diene conjugates, malonic dialdehyde, Schiff bases) and tocopherol. Enhanced lipid peroxidation in the heart was completely compensated by activation of antioxidative enzymes. The content of all lipid peroxidation products measured in the liver increased; this was accompanied by a decrease of glutathione peroxidase and an increase of superoxide dismutase activities. It is suggested that lipid peroxidation was activated in response to altered gravity.

  5. Avoiding the Perfect Storm: The Biologic and Clinical Case for Reevaluating the 7-Day Expectation for Methicillin-Resistant Staphylococcus aureus Bacteremia Before Switching Therapy

    PubMed Central

    Goldstein, Ellie J. C.; Kullar, Ravina; McKinnell, James A.; Sakoulas, George

    2014-01-01

    Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (MRSAB) is associated with poor outcomes and serious complications. The MRSA guidelines define treatment failure and persistent bacteremia as lasting ≥7 days; however, this definition requires reevaluation. Aggressively reducing the bacterial inoculum promptly is critical because factors already in place before clinical presentation are driving resistance to the few antibiotics that are available to treat MRSAB. Alternative approaches to treat MRSAB should be considered within 3–4 days of persistent MRSAB. With rapid molecular diagnostics emerging in clinical microbiology laboratories and biomarkers as a potential for early patient risk stratification, a future shorter threshold may become possible. PMID:25048852

  6. Linear integrated circuits

    NASA Astrophysics Data System (ADS)

    Young, T.

    This book is intended to be used as a textbook in a one-semester course at a variety of levels. Because of self-study features incorporated, it may also be used by practicing electronic engineers as a formal and thorough introduction to the subject. The distinction between linear and digital integrated circuits is discussed, taking into account digital and linear signal characteristics, linear and digital integrated circuit characteristics, the definitions for linear and digital circuits, applications of digital and linear integrated circuits, aspects of fabrication, packaging, and classification and numbering. Operational amplifiers are considered along with linear integrated circuit (LIC) power requirements and power supplies, voltage and current regulators, linear amplifiers, linear integrated circuit oscillators, wave-shaping circuits, active filters, DA and AD converters, demodulators, comparators, instrument amplifiers, current difference amplifiers, analog circuits and devices, and aspects of troubleshooting.

  7. Patient ventilator interfaces: practical aspects in the chronic situation.

    PubMed

    Clini, E

    1997-02-01

    In the ventilator-dependent patient, the nonpsychological problems of the chronic phase relate mainly to aspects of the patient ventilator interface. Humidification, suctioning of secretions, and ventilatory circuit and monitoring are the three most important aspects to which careful attention is needed. Good humidification can be obtained by means of various devices, which can provide humidity directly or indirectly: in the tracheostomized patient, the heat and moisture exchanger appears to be a good method because of its antibacterial properties. Airway suctioning is frequently needed in patients receiving ventilation invasively. Suctioning of secretions might possibly be associated with the risk of major cardiorespiratory complications: bacterial colonization of the airways and the subsequent increased risk of infection should be carefully considered. Problems concerning the ventilatory circuit and monitoring can be specific in patients with a tracheal cannula and those with a nasal/facial interface. Long-term tracheostomy in itself represents a real risk for bacterial colonization, damage to the tracheal mucosa, and to functioning of the vocal cords (both for speech and swallowing): therefore, a switch from invasive to noninvasive ventilatory interface may be proposed. Most problems with the nasal mask interface concern air leakage and the skin mucosal lesions. Two major aspects must be taken into account when considering the long-term effects of noninvasive ventilatory support monitoring: the possible effect of CO2 rebreathing, and the inadequate volume/pressure delivery, so that proper ventilation cannot be achieved. Use of an oral/mouth interface is of limited interest in subjects with restrictive disorders: air gastric distension and orthodontic problems are the most common side-effects in chronic use.

  8. Ventilator-Associated Tracheitis in Children: Does Antibiotic Duration Matter?

    PubMed Central

    Turnbull, Alison E.; Milstone, Aaron M.; Lehmann, Christoph U.; Sydnor, Emily R. M.; Cosgrove, Sara E.

    2011-01-01

    Background. The optimal duration of antibiotic therapy for ventilator-associated tracheitis (VAT) has not been defined, which may result in unnecessarily prolonged courses of antibiotics. The primary objective of this study was to determine whether prolonged-course (≥7 days in duration) therapy for VAT was more protective against progression to hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP), compared with short-course antibiotics (<7 days in duration). The secondary objective was to determine whether prolonged-course therapy was more likely to result in the acquisition of multidrug-resistant organisms (MDROs) compared with short-course therapy. Methods. We conducted a retrospective cohort study of children ≤18 years of age hospitalized in the intensive care unit and intubated for ≥48 h from January 2007 through December 2009 who received antibiotic therapy for VAT. Results. Of the 1616 patients intubated for at least 48 h, 150 received antibiotics for clinician-suspected VAT, although only 118 of these patients met VAT criteria. Prolonged-course antibiotics were not protective against subsequent development of HAP or VAP (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.40–2.91). Factors associated with subsequent MDRO colonization or infection included prolonged-course antibiotic therapy (HR, 5.15; 95% CI, 1.54–7.19), receipt of combination antibiotic therapy (HR, 3.24; 95% CI, 1.54–6.82), and days of hospital exposure prior to completing antibiotic therapy (HR, 1.08; 95% CI, 1.04–1.12). Conclusions. A prolonged course of antibiotics for VAT does not appear to protect against progression to HAP or VAP compared with short-course therapy. Furthermore, prolonged antibiotic courses were associated with a significantly increased risk of subsequent MDRO acquisition. PMID:21540205

  9. [Risk factors for periventricular-intraventricular hemorrhage in premature infants treated with mechanical ventilation].

    PubMed

    Xu, Fa-Lin; Duan, Jia-Jia; Zhang, Yan-Hua; Zhang, Xiao-Li; Guo, Jia-Jia

    2012-11-01

    To study risk factors for periventricular-intraventricular hemorrhage (PVH-IVH) in premature infants treated with mechanical ventilation. A total of 205 premature infants who were admitted to the neonatal intensive care unit (NICU) and treated with mechanical ventilation between January 2009 and December 2011 were enrolled. They were classified into PVH-IVH and non-PVH-IVH groups according to the results of head ultrasonography performed at 3 to 7 days after birth. Single factor and multivariate logistic regression analysis were used to identify risk factors for PVH-IVH. Single factor analysis indicated 9 factors associated with the development of PVH-IVH, including a gestational age of <32 weeks, a birth weight of <1500 g, intrauterine distress, severe asphyxia, vaginal delivery, maternal perinatal infection, premature rupture of membranes (PROM) at ≥8 hours, mechanical ventilation duration of ≥7 days and ventilator-associated pneumonia (VAP) (P<0.05). Multivariate logistic regression analysis showed that a birth weight of <1500 g (OR=2.665), intrauterine distress (OR=2.177), severe asphyxia (OR=5.653), maternal perinatal infection (OR=4.365) and VAP (OR=2.299) were independent risk factors for the development of PVH-IVH (P<0.05). Very low birth weight, intrauterine distress, severe asphyxia, maternal perinatal infection and VAP are closely associated with an increased risk of PVH-IVH in premature infants treated with mechanical ventilation. These clinical risk factors should be given more attention in the prevention of PVH-IVH.

  10. Design and effectiveness of a membrane-pump-driven ventilator for mice.

    PubMed

    Winning, Johannes; Huwer, Hanno; Redjai, Jasmin; Naumann, Christian; Winning, Ilka; Bauer, Michael

    2005-01-01

    To perform mechanical ventilation of mice in the absence of highly expensive commercially available devices, we developed a membrane-pump-driven respirator and studied its practicability. The continuous airflow generated by the membrane pump was changed into an intermittent flow by using a multifunction timer. Tidal volume was adjusted by a rotary dimmer regulating the electric power onto the pump. The expiration air left the circuit through openings at the tube connection. Mice were ventilated with room air for 5 h with a tidal volume of approximately 200 muL. In group 1 (n = 6), ventilation was performed with a frequency of 110 min-1, in group 2 (n = 6) with a frequency of 150 min-1. Spontaneously breathing anesthetized mice (n = 6) served as controls. In addition we performed single-lung open-chest ventilation for 1 h in two animals. The parameters of arterial blood gas analyses were within the normal range except for moderate hyperventilation in group 2. Single-lung ventilation led to a significant decline (P < 0.05) of pO2 and SO2, whereas the pCO2 remained within the normal range. Respiratory rate, tidal volume and pressure limitation can be adjusted for optimal ventilation. In addition, the device provides a minimalized dead space and impedes potential alveolar damage caused by negative pressure generated by spontaneous inspiration during positive-pressure ventilation.

  11. Sense circuit arrangement

    NASA Technical Reports Server (NTRS)

    Bohning, Oliver D. (Inventor)

    1976-01-01

    A unique, two-node sense circuit is disclosed. The circuit includes a bridge comprised of resistance elements and a differential amplifier. The two-node circuit is suitably adapted to be arranged in an array comprised of a plurality of discrete bridge-amplifiers which can be selectively energized. The circuit is arranged so as to form a configuration with minimum power utilization and a reduced number of components and interconnections therebetween.

  12. Ventilation Model and Analysis Report

    SciTech Connect

    V. Chipman

    2003-07-18

    This model and analysis report develops, validates, and implements a conceptual model for heat transfer in and around a ventilated emplacement drift. This conceptual model includes thermal radiation between the waste package and the drift wall, convection from the waste package and drift wall surfaces into the flowing air, and conduction in the surrounding host rock. These heat transfer processes are coupled and vary both temporally and spatially, so numerical and analytical methods are used to implement the mathematical equations which describe the conceptual model. These numerical and analytical methods predict the transient response of the system, at the drift scale, in terms of spatially varying temperatures and ventilation efficiencies. The ventilation efficiency describes the effectiveness of the ventilation process in removing radionuclide decay heat from the drift environment. An alternative conceptual model is also developed which evaluates the influence of water and water vapor mass transport on the ventilation efficiency. These effects are described using analytical methods which bound the contribution of latent heat to the system, quantify the effects of varying degrees of host rock saturation (and hence host rock thermal conductivity) on the ventilation efficiency, and evaluate the effects of vapor and enhanced vapor diffusion on the host rock thermal conductivity.

  13. Piezoelectric drive circuit

    DOEpatents

    Treu, Jr., Charles A.

    1999-08-31

    A piezoelectric motor drive circuit is provided which utilizes the piezoelectric elements as oscillators and a Meacham half-bridge approach to develop feedback from the motor ground circuit to produce a signal to drive amplifiers to power the motor. The circuit automatically compensates for shifts in harmonic frequency of the piezoelectric elements due to pressure and temperature changes.

  14. Piezoelectric drive circuit

    DOEpatents

    Treu, C.A. Jr.

    1999-08-31

    A piezoelectric motor drive circuit is provided which utilizes the piezoelectric elements as oscillators and a Meacham half-bridge approach to develop feedback from the motor ground circuit to produce a signal to drive amplifiers to power the motor. The circuit automatically compensates for shifts in harmonic frequency of the piezoelectric elements due to pressure and temperature changes. 7 figs.

  15. Integrated Circuit Computer Analysis.

    DTIC Science & Technology

    information on this topic. The most important findings were the method used to identify combinational circuits ( Quine - McCluskey algorithm) and a clearly...defined set of limits on the problem of identifying sequential circuits. Since the Quine - McCluskey algorithm works only for combinational circuits, an

  16. Electrical Circuit Simulation Code

    SciTech Connect

    Wix, Steven D.; Waters, Arlon J.; Shirley, David

    2001-08-09

    Massively-Parallel Electrical Circuit Simulation Code. CHILESPICE is a massively-arallel distributed-memory electrical circuit simulation tool that contains many enhanced radiation, time-based, and thermal features and models. Large scale electronic circuit simulation. Shared memory, parallel processing, enhance convergence. Sandia specific device models.

  17. Genealogy of Chua's Circuit

    NASA Astrophysics Data System (ADS)

    Kennedy, Peter

    2013-01-01

    Since its invention in 1983, Chua's circuit has become a reference circuit for studying bifurcations and chaos. This chapter plots the evolution of the circuit from the original simulations and experimental realization of a five-element topology with a three-segment nonlinear resistor to the latest three-element design comprising a capacitor, an inductor, and a memristor.

  18. Optimal Delivery of Aerosols to Infants During Mechanical Ventilation

    PubMed Central

    Azimi, Mandana; Hindle, Michael

    2014-01-01

    Abstract Purpose: The objective of this study was to determine optimal aerosol delivery conditions for a full-term (3.6 kg) infant receiving invasive mechanical ventilation by evaluating the effects of aerosol particle size, a new wye connector, and timing of aerosol delivery. Methods: In vitro experiments used a vibrating mesh nebulizer and evaluated drug deposition fraction and emitted dose through ventilation circuits containing either a commercial (CM) or new streamlined (SL) wye connector and 3-mm endotracheal tube (ETT) for aerosols with mass median aerodynamic diameters of 880 nm, 1.78 μm, and 4.9 μm. The aerosol was released into the circuit either over the full inhalation cycle (T1 delivery) or over the first half of inhalation (T2 delivery). Validated computational fluid dynamics (CFD) simulations and whole-lung model predictions were used to assess lung deposition and exhaled dose during cyclic ventilation. Results: In vitro experiments at a steady-state tracheal flow rate of 5 L/min resulted in 80–90% transmission of the 880-nm and 1.78-μm aerosols from the ETT. Based on CFD simulations with cyclic ventilation, the SL wye design reduced depositional losses in the wye by a factor of approximately 2–4 and improved lung delivery efficiencies by a factor of approximately 2 compared with the CM device. Delivery of the aerosol over the first half of the inspiratory cycle (T2) reduced exhaled dose from the ventilation circuit by a factor of 4 compared with T1 delivery. Optimal lung deposition was achieved with the SL wye connector and T2 delivery, resulting in 45% and 60% lung deposition for optimal polydisperse (∼1.78 μm) and monodisperse (∼2.5 μm) particle sizes, respectively. Conclusions: Optimization of selected factors and use of a new SL wye connector can substantially increase the lung delivery efficiency of medical aerosols to infants from current values of <1–10% to a range of 45–60%. PMID:24299500

  19. Optimal delivery of aerosols to infants during mechanical ventilation.

    PubMed

    Longest, P Worth; Azimi, Mandana; Hindle, Michael

    2014-10-01

    The objective of this study was to determine optimal aerosol delivery conditions for a full-term (3.6 kg) infant receiving invasive mechanical ventilation by evaluating the effects of aerosol particle size, a new wye connector, and timing of aerosol delivery. In vitro experiments used a vibrating mesh nebulizer and evaluated drug deposition fraction and emitted dose through ventilation circuits containing either a commercial (CM) or new streamlined (SL) wye connector and 3-mm endotracheal tube (ETT) for aerosols with mass median aerodynamic diameters of 880 nm, 1.78 μm, and 4.9 μm. The aerosol was released into the circuit either over the full inhalation cycle (T1 delivery) or over the first half of inhalation (T2 delivery). Validated computational fluid dynamics (CFD) simulations and whole-lung model predictions were used to assess lung deposition and exhaled dose during cyclic ventilation. In vitro experiments at a steady-state tracheal flow rate of 5 L/min resulted in 80-90% transmission of the 880-nm and 1.78-μm aerosols from the ETT. Based on CFD simulations with cyclic ventilation, the SL wye design reduced depositional losses in the wye by a factor of approximately 2-4 and improved lung delivery efficiencies by a factor of approximately 2 compared with the CM device. Delivery of the aerosol over the first half of the inspiratory cycle (T2) reduced exhaled dose from the ventilation circuit by a factor of 4 compared with T1 delivery. Optimal lung deposition was achieved with the SL wye connector and T2 delivery, resulting in 45% and 60% lung deposition for optimal polydisperse (∼1.78 μm) and monodisperse (∼2.5 μm) particle sizes, respectively. Optimization of selected factors and use of a new SL wye connector can substantially increase the lung delivery efficiency of medical aerosols to infants from current values of <1-10% to a range of 45-60%.

  20. Spermatozoa isolated from cat testes retain their structural integrity as well as a developmental potential after refrigeration for up to 7 days.

    PubMed

    Buarpung, Sirirak; Tharasanit, Theerawat; Thongkittidilok, Chommanart; Comizzoli, Pierre; Techakumphu, Mongkol

    2015-10-01

    The objective of this study was to compare the efficiency of preservation media for isolated feline testicular spermatozoa as well as the concentrations of bovine serum albumin (BSA) on: (1) the membrane (sperm membrane integrity (SMI)) and DNA integrity of spermatozoa; and (2) the developmental potential of spermatozoa after intracytoplasmic sperm injection (ICSI). Isolated cat spermatozoa were stored in HEPES-M199 medium (HM) or Dulbecco's phosphate-buffered saline (DPBS) at 4°C for up to 7 days. Results indicated that HM maintained a better SMI than DPBS throughout the storage periods (P > 0.05). When spermatozoa were stored in HM supplemented with BSA at different concentrations (4, 8 or 16 mg/ml), SMI obtained from HM containing 8 and 16 mg/ml BSA was higher than with 4 mg/ml BSA (P 0.05). In summary, cat spermatozoa immediately isolated from testicular tissue can be stored as a suspension in basic buffered medium at 4°C for up to 7 days. BSA supplementation into the medium improves membrane integrity of the spermatozoa during cold storage. Testicular spermatozoa stored in HM containing 16 mg/ml BSA retained full in vitro developmental potential after ICSI, similar to that of fresh controls even though DNA integrity had slightly declined.

  1. A replication of the 5-7 day dream-lag effect with comparison of dreams to future events as control for baseline matching.

    PubMed

    Blagrove, Mark; Henley-Einion, Josie; Barnett, Amanda; Edwards, Darren; Heidi Seage, C

    2011-06-01

    The dream-lag effect refers to there being, after the frequent incorporation of memory elements from the previous day into dreams (the day-residue), a lower incorporation of memory elements from 2 to 4 days before the dream, but then an increased incorporation of memory elements from 5 to 7 days before the dream. Participants (n=8, all female) kept a daily diary and a dream diary for 14 days and then rated the level of matching between every dream report and every daily diary record. Baseline matching was assessed by comparing all dream reports to all diary records for days that occurred after the dream. A significant dream-lag effect for the 5-7 day period, compared to baseline and compared to the 2-4 day period, was found. This may indicate a memory processing function for sleep, which the dream content may reflect. Participants' and three independent judges' mean ratings also confirmed a significant day-residue effect. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Follicular development in a 7-day versus 4-day hormone-free interval with an oral contraceptive containing 20 mcg ethinyl estradiol and 1 mg norethindrone acetate.

    PubMed

    Rible, Radhika D; Taylor, DeShawn; Wilson, Melissa L; Stanczyk, Frank Z; Mishell, Daniel R

    2009-03-01

    Combined oral contraceptive (COC) formulations with 20 mcg ethinyl estradiol (EE) have a greater incidence of ovarian hormone production and follicular development, which can be managed by shortening the number of hormone-free days per COC cycle. This study evaluates differences in follicular development during a 7-day versus 4-day hormone-free interval in a COC regimen with 20 mcg EE and 1 mg norethindrone acetate. Forty-one healthy women were randomized in an open-label fashion to this formulation in either a 24/4 or a 21/7 day regimen for three cycles. Estradiol, progesterone, follicle-stimulating hormone, luteinizing hormone and inhibin B were measured daily from Cycle 2, Day 21 to Cycle 3, Day 3 and on Day 7 of Cycle 3. Follicular diameter and Hoogland score were calculated on Cycle 2, Days 21, 24 and 28 and Cycle 3, Days 3 and 7. Sixty-six percent of subjects in the 21/7 group and 70% of the subjects in the 24/4 group developed a follicle greater than 10 mm diameter. Ovarian steroid hormone levels, Hoogland scores and bleeding patterns were not statistically significant between the groups. In contrast to prior studies, this analysis suggests no difference in follicle development or bleeding patterns among women receiving a 21/7 or 24/4 regimen of a 20-mcg EE/1-mg norethindrone acetate COC.

  3. Miners' Misconceptions of Flow Distribution Within Circuits as a Factor Influencing Underground Mining Accidents.

    NASA Astrophysics Data System (ADS)

    Passaro, Perry David

    Misconceptions can be thought of as naive approaches to problem solving that are perceptually appealing but incorrect and inconsistent with scientific evidence (Piaget, 1929). One type of misconception involves flow distributions within circuits. This concept is important because miners' conceptual errors about flow distribution changes within complex circuits may be in part responsible for fatal mine disasters. Based on the theory that misconceptions of flow distribution changes within circuits were responsible for underground mine disasters involving mine ventilation circuits, a series of studies was undertaken with mining engineering students, professional mining engineers, as well as mine foremen, mine supervisors, mine rescue members, mine maintenance personnel, mining researchers and working miners to identify these conceptual errors and errors in mine ventilation procedures. Results indicate that misconceptions of flow distribution changes within circuits exist in over 70 percent of the subjects sampled. It is assumed that these misconceptions of flow distribution changes within circuits result in errors of judgment when miners are faced with inferring and changing ventilation arrangements when two or more mine sections are connected. Furthermore, it is assumed that these misconceptions are pervasive in the mining industry and may be responsible for at least two mine ventilation disasters. The findings of this study are consistent with Piaget's (1929) model of figurative and operative knowledge. This model states that misconceptions are in part due to a lack of knowledge of dynamic transformations and how to apply content information. Recommendations for future research include the development of an interactive expert system for training miners with ventilation arrangements. Such a system would meet the educational recommendations made by Piaget (1973b) by involving a hands-on approach that allows discovery, interaction, the opportunity to make mistakes and

  4. CIRCUITS FOR CURRENT MEASUREMENTS

    DOEpatents

    Cox, R.J.

    1958-11-01

    Circuits are presented for measurement of a logarithmic scale of current flowing in a high impedance. In one form of the invention the disclosed circuit is in combination with an ionization chamber to measure lonization current. The particular circuit arrangement lncludes a vacuum tube having at least one grid, an ionization chamber connected in series with a high voltage source and the grid of the vacuum tube, and a d-c amplifier feedback circuit. As the ionization chamber current passes between the grid and cathode of the tube, the feedback circuit acts to stabilize the anode current, and the feedback voltage is a measure of the logaritbm of the ionization current.

  5. Mitochondrial ion circuits.

    PubMed

    Nicholls, David G

    2010-01-01

    Proton circuits across the inner mitochondrial membrane link the primary energy generators, namely the complexes of the electron transport chain, to multiple energy utilizing processes, including the ATP synthase, inherent proton leak pathways, metabolite transport and linked circuits of sodium and calcium. These mitochondrial circuits can be monitored in both isolated preparations and intact cells and, for the primary proton circuit techniques, exist to follow both the proton current and proton electrochemical potential components of the circuit in parallel experiments, providing a quantitative means of assessing mitochondrial function and, equally importantly, dysfunction.

  6. Use of airway pressure release ventilation is associated with a reduced incidence of ventilator-associated pneumonia in patients with pulmonary contusion.

    PubMed

    Walkey, Allan J; Nair, Sunil; Papadopoulos, Stella; Agarwal, Suresh; Reardon, Christine C

    2011-03-01

    Past studies suggest that airway pressure release ventilation (APRV) is associated with reduced sedative requirements and increased recruitment of atelectatic lung, two factors that might reduce the risk for ventilator-associated pneumonia (VAP). We investigated whether APRV might be associated with a decreased risk for VAP in patients with pulmonary contusion. Retrospective cohort study. Of 286, 64 (22%) patients requiring mechanical ventilation for >48 hours met criteria for pulmonary contusion and were the basis for this study. Subjects with pulmonary contusion had a significantly higher rate of VAP than other trauma patients, [VAP rate contusion patients: 18.3/1,000, non-contusion patients: 7.7/1,000, incidence rate ratio 2.37 (95% confidence interval [CI], 1.11-4.97), p=0.025]. Univariate analysis showed that APRV (hazard ratio, 0.15 [0.03-0.72; p=0.018]) was associated with a decreased incidence of VAP. Cox proportional hazards regression, using propensity scores for APRV to control for confounding, supported a protective effect of APRV from VAP (hazard ratio, 0.10 [95% CI, 0.02-0.58]; p=0.01). Pao2/FiO2 ratios were higher during APRV compared with conventional ventilation (p<0.001). Subjects attained the goal Sedation Agitation Score for an increased percentage of time during APRV (median [interquartile range (IQR)] 72.7% [33-100] of the time) compared with conventional ventilation (47.2% [0-100], p=0.044), however, dose of sedatives was not different between these subjects. APRV was not associated with hospital mortality (odds ratio 0.57 [95% CI, 0.06-5.5]; p=0.63) or ventilator-free days (No APRV 15.4 vs. APRV 13.7 days, p=0.49). Use of APRV in patients with pulmonary contusion is associated with a reduced risk for VAP. Copyright © 2011 by Lippincott Williams & Wilkins

  7. Precise control of end-tidal carbon dioxide levels using sequential rebreathing circuits.

    PubMed

    Somogyi, R B; Vesely, A E; Preiss, D; Prisman, E; Volgyesi, G; Azami, T; Iscoe, S; Fisher, J A; Sasano, H

    2005-12-01

    Anaesthesiologists have traditionally been consulted to help design breathing circuits to attain and maintain target end-tidal carbon dioxide (P(ET)CO2). The methodology has recently been simplified by breathing circuits that sequentially deliver fresh gas (not containing carbon dioxide (CO2)) and reserve gas (containing CO2). Our aim was to determine the roles of fresh gas flow, reserve gas PCO2 and minute ventilation in the determination of P(ET)CO2. We first used a computer model of a non-rebreathing sequential breathing circuit to determine these relationships. We then tested our model by monitoring P(ET)CO2 in human volunteers who increased their minute ventilation from resting to five times resting levels. The optimal settings to maintain P(ET)CO2 independently of minute ventilation are 1) fresh gas flow equal to minute ventilation minus anatomical deadspace ventilation, and 2) reserve gas PCO2 equal to alveolar PCO2. We provide an equation to assist in identifying gas settings to attain a target PCO2. The ability to precisely attain and maintain a target PCO2 (isocapnia) using a sequential gas delivery circuit has multiple therapeutic and scientific applications.

  8. Ventilator risk management using a programmed monitor.

    PubMed

    Silvern, D A; Gupte, P M

    1989-01-01

    A computer program was written to improve quality control and risk management of patients on ventilators. The software was designed to run on the new-generation Spacelabs PC Monitor interfaced to the Puritan-Bennett 7200a ventilator. Before the program allows connection of the ventilator to a patient, the ventilator is polled for initial hardware status, alarm statuses and alarm limit settings. If there are no hardware failures, alarm violations, or improperly set alarm limits, the program prompts the clinician to connect the ventilator to the patient. Polling is done periodically after patient ventilation begins, and patient data, alarm conditions, or changes to the ventilator settings are automatically written to disk. In addition, real-time data can be displayed at any time during the ventilation session by using a set of touch-screen options. After the ventilation session is complete, the clinician can print the final report in hard copy or to disk.

  9. The Johannesburg A-D circuit switch. A valve device for converting a co-axial Mapleson D into a co-axial Mapleson A system.

    PubMed

    Manicom, A W; Schoonbee, C G

    1979-12-01

    A simple valve device is described for a co-axial tubing anaesthetic system which enables selection of the circuit characteristics of either a modified Mapleson A system for spontaneous breathing or a modified Mapleson D system for controlled ventilation. Thus, the system allows an economical fresh gas flow to be used during either controlled or spontaneous ventilation. The mode of ventilation may be changed during anaesthesia without adjusting the patient tubing or the attachment of the system to the anaesthetic machine.

  10. Fluid flow and particle transport in mechanically ventilated airways. Part I. Fluid flow structures.

    PubMed

    Van Rhein, Timothy; Alzahrany, Mohammed; Banerjee, Arindam; Salzman, Gary

    2016-07-01

    A large eddy simulation-based computational study of fluid flow and particle transport in upper tracheobronchial airways is carried out to investigate the effect of ventilation parameters on pulmonary fluid flow. Respiratory waveforms commonly used by commercial mechanical ventilators are used to study the effect of ventilation parameters and ventilation circuit on pulmonary fluid dynamics. A companion paper (Alzahrany et al. in Med Biol Eng Comput, 2014) reports our findings on the effect of the ventilation parameters and circuit on particle transport and aerosolized drug delivery. The endotracheal tube (ETT) was found to be an important geometric feature and resulted in a fluid jet that caused an increase in turbulence and created a recirculation zone with high wall shear stress in the main bronchi. Stronger turbulence was found in lower airways than would be found under normal breathing conditions due to the presence of the jet caused by the ETT. The pressure-controlled sinusoidal waveform induced the lowest wall shear stress on the airways wall.

  11. Residential ventilation standards scoping study

    SciTech Connect

    McKone, Thomas E.; Sherman, Max H.

    2003-10-01

    The goals of this scoping study are to identify research needed to develop improved ventilation standards for California's Title 24 Building Energy Efficiency Standards. The 2008 Title 24 Standards are the primary target for the outcome of this research, but this scoping study is not limited to that timeframe. We prepared this scoping study to provide the California Energy Commission with broad and flexible options for developing a research plan to advance the standards. This document presents the findings of a scoping study commissioned by the Public Interest Energy Research (PIER) program of the California Energy Commission to determine what research is necessary to develop new residential ventilation requirements for California. This study is one of three companion efforts needed to complete the job of determining the ventilation needs of California residences, determining the bases for setting residential ventilation requirements, and determining appropriate ventilation technologies to meet these needs and requirements in an energy efficient manner. Rather than providing research results, this scoping study identifies important research questions along with the level of effort necessary to address these questions and the costs, risks, and benefits of pursuing alternative research questions. In approaching these questions and corresponding levels of effort, feasibility and timing were important considerations. The Commission has specified Summer 2005 as the latest date for completing this research in time to update the 2008 version of California's Energy Code (Title 24).

  12. NanoClusters Enhance Drug Delivery in Mechanical Ventilation

    NASA Astrophysics Data System (ADS)

    Pornputtapitak, Warangkana

    The overall goal of this thesis was to develop a dry powder delivery system for patients on mechanical ventilation. The studies were divided into two parts: the formulation development and the device design. The pulmonary system is an attractive route for drug delivery since the lungs have a large accessible surface area for treatment or drug absorption. For ventilated patients, inhaled drugs have to successfully navigate ventilator tubing and an endotracheal tube. Agglomerates of drug nanoparticles (also known as 'NanoClusters') are fine dry powder aerosols that were hypothesized to enable drug delivery through ventilator circuits. This Thesis systematically investigated formulations of NanoClusters and their aerosol performance in a conventional inhaler and a device designed for use during mechanical ventilation. These engineered powders of budesonide (NC-Bud) were delivered via a MonodoseRTM inhaler or a novel device through commercial endotracheal tubes, and analyzed by cascade impaction. NC-Bud had a higher efficiency of aerosol delivery compared to micronized stock budesonide. The delivery efficiency was independent of ventilator parameters such as inspiration patterns, inspiration volumes, and inspiration flow rates. A novel device designed to fit directly to the ventilator and endotracheal tubing connections and the MonodoseRTM inhaler showed the same efficiency of drug delivery. The new device combined with NanoCluster formulation technology, therefore, allowed convenient and efficient drug delivery through endotracheal tubes. Furthermore, itraconazole (ITZ), a triazole antifungal agent, was formulated as a NanoCluster powder via milling (top-down process) or precipitation (bottom-up process) without using any excipients. ITZ NanoClusters prepared by wet milling showed better aerosol performance compared to micronized stock ITZ and ITZ NanoClusters prepared by precipitation. ITZ NanoClusters prepared by precipitation methods also showed an amorphous state

  13. Parallelizing quantum circuit synthesis

    NASA Astrophysics Data System (ADS)

    Di Matteo, Olivia; Mosca, Michele

    2016-03-01

    Quantum circuit synthesis is the process in which an arbitrary unitary operation is decomposed into a sequence of gates from a universal set, typically one which a quantum computer can implement both efficiently and fault-tolerantly. As physical implementations of quantum computers improve, the need is growing for tools that can effectively synthesize components of the circuits and algorithms they will run. Existing algorithms for exact, multi-qubit circuit synthesis scale exponentially in the number of qubits and circuit depth, leaving synthesis intractable for circuits on more than a handful of qubits. Even modest improvements in circuit synthesis procedures may lead to significant advances, pushing forward the boundaries of not only the size of solvable circuit synthesis problems, but also in what can be realized physically as a result of having more efficient circuits. We present a method for quantum circuit synthesis using deterministic walks. Also termed pseudorandom walks, these are walks in which once a starting point is chosen, its path is completely determined. We apply our method to construct a parallel framework for circuit synthesis, and implement one such version performing optimal T-count synthesis over the Clifford+T gate set. We use our software to present examples where parallelization offers a significant speedup on the runtime, as well as directly confirm that the 4-qubit 1-bit full adder has optimal T-count 7 and T-depth 3.

  14. Vaccination against foot-and-mouth disease virus confers complete clinical protection in 7 days and partial protection in 4 days: Use in emergency outbreak response.

    PubMed

    Golde, William T; Pacheco, Juan M; Duque, Hernando; Doel, Timothy; Penfold, Barry; Ferman, Geoffrey S; Gregg, Douglas R; Rodriguez, Luis L

    2005-12-30

    Recent outbreaks of foot-and-mouth disease virus (FMDV) demonstrate that this highly contagious viral infection of cloven hoofed animals continues to be a significant economic problem worldwide. Debate about the most effective way to respond to outbreaks of FMDV in disease free countries continues to center on the use of vaccines. In this report, we present data showing that a commercially available, standard dose vaccine formulation can fully protect cattle against direct challenge with the virus in as little as 7 days with no carrier transmission to naïve animals. Cattle challenged 4 days after vaccination have reduced disease severity, no detectable virus in blood and little virus shedding from nasal secretions. These significant effects at 4 days post vaccination, confirmed in two separate trials, support the value of using currently available vaccines as a first line of defense against foot-and-mouth disease (FMD) outbreaks.

  15. Biodistribution of PLGA and PLGA/chitosan nanoparticles after repeat-dose oral delivery in F344 rats for 7 days

    PubMed Central

    Navarro, Sara M; Darensbourg, Caleb; Cross, Linda; Stout, Rhett; Coulon, Diana; Astete, Carlos E; Morgan, Timothy; Sabliov, Cristina M

    2015-01-01

    Aim To quantify in vivo the biodistribution of poly(lactic-co-glycolic) acid (PLGA) and PLGA/chitosan nanoparticles (PLGA/Chi NPs) and assess if the positive charge of chitosan significantly enhances nanoparticle absorption in the GI tract. Material & methods PLGA and PLGA/Chi NPs covalently linked to tetramethylrhodamine-5-isothiocyanate (TRITC) were orally administered to F344 rats for 7 days, and the biodistribution of fluorescent NPs was analyzed in different organs. Results The highest amount of particles (% total dose/g) was detected for both treatments in the spleen, followed by intestine and kidney, and then by liver, lung, heart and brain, with no significant difference between PLGA and PLGA/Chi NPs. Conclusion Only a small percentage of orally delivered NPs was detected in the analyzed organs. The positive charge conferred by chitosan was not sufficient to improve the absorption of the PLGA/Chi NPs over that of PLGA NPs. PMID:25491670

  16. [Effect of mechanic stimulation of foot support zones during 7-day dry immersion on alterations of ocular saccades kinematics associated with immersion].

    PubMed

    Zobova, L N; Miller, N V; Badakva, A M

    2010-01-01

    Purpose of the investigation was to evaluate how daily sessions of mechanic stimulation (MS) of foot support zones applied to mitigate the effects of lack of support loading on the postural muscles influence ocular saccades during prolonged support deprivation. According to the experimental protocol, before and immediately after 7-day dry immersion, 4 control and 4 MC human subjects (experimental group) implemented the test of rapid blanking light target appearing on the visual field periphery. Eye motions were detected using infrared images obtained at 200 Hz. Analysis of normalized and consolidated data showed that MC of foot support zones moderated significantly alterations in ocular saccade kinematics associated with support load deprivation confirmed by recruitment of support afferentation in sensory input to mechanisms of ocular saccade generation.

  17. [Evolution of non-invasive ventilation in acute bronchiolitis].

    PubMed

    Toledo del Castillo, B; Fernández Lafever, S N; López Sanguos, C; Díaz-Chirón Sánchez, L; Sánchez da Silva, M; López-Herce Cid, J

    2015-08-01

    The aim of the study was to analyse the evolution, over a12-year period, of the use of non-invasive (NIV) and invasive ventilation (IV) in children admitted to a Paediatric Intensive Care Unit (PICU) due to acute bronchiolitis. A retrospective observational study was performed including all children who were admitted to the PICU requiring NIV or IV between 2001 and 2012. Demographic characteristics, ventilation assistance and clinical outcome were analysed. A comparison was made between the first six years and the last 6 years of the study. A total of 196 children were included; 30.1% of the subjects required IV and 93.3% required NIV. The median duration of IV was 9.5 days and NIV duration was 3 days. The median PICU length of stay was 7 days, and 2% of the patients died. The use of NIV increased from 79.4% in first period to 100% in the second period (P<.0001) and IV use decreased from 46% in first period to 22.6% in the last 6 years (P<.0001). Continuous positive airway pressure and nasopharyngeal tube were the most frequently used modality and interface, although the use of bi-level non-invasive ventilation (P<.001) and of nasal cannulas significantly increased (P<.0001) in the second period, and the PICU length of stay was shorter (P=.011). The increasing use of NIV in bronchiolitis in our PICU during the last 12 years was associated with a decrease in the use of IV and length of stay in the PICU. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  18. Addition of 7 Days of Zidovudine plus Lamivudine to Peripartum Single-Dose Nevirapine Effectively Reduces Nevirapine Resistance Postpartum in HIV-Infected Mothers in Malawi

    PubMed Central

    Farr, Sherry L.; Nelson, Julie A.E.; Ng’ombe, Thokozani J.; Kourtis, Athena P.; Chasela, Charles; Johnson, Jeffrey A.; Kashuba, Angela D.M.; Tegha, Gerald L.; Wiener, Jeffrey; Eron, Joseph J.; Banda, Harriet N.; Mpaso, Mwanangwa; Lipscomb, Jonathan; Matiki, Chrissie; Fiscus, Susan A.; Jamieson, Denise J.; van der Horst, Charles

    2010-01-01

    Background We assessed whether 7 days of zidovudine+lamivudine postpartum with single-dose nevirapine at labor decreases nevirapine resistance in HIV-infected women in Malawi. Methods HIV-infected pregnant women receiving intrapartum single-dose nevirapine and 7 days of zidovudine+lamivudine (n=132), and women receiving intrapartum single-dose nevirapine alone (n=66) were followed from an antenatal visit through 6 weeks postpartum. Plasma specimens at 2 and 6 weeks postpartum were tested for genotypic resistance to nevirapine by population sequencing and sensitive real-time PCR. Poisson regression was used to determine predictors of postpartum nevirapine resistance. Results Median HIV RNA was similar at entry (4.27 log vs. 4.35 log, p=0.87), differed at 2 weeks postpartum (2.67 log vs. 3.58 log, p<0.0001), but not at 6 weeks postpartum (4.49 log vs. 4.40 log, p=0.79), between single-dose nevirapine/zidovudine+lamivudine and single-dose nevirapine groups, respectively. Nevirapine resistance, measured by population sequencing and sensitive real-time PCR, was significantly less common in those receiving single-dose nevirapine/zidovudine+lamivudine compared to single-dose nevirapine, respectively, at 2 weeks (10% (4/40) vs. 74% (31/42), p<0.0001) and 6 weeks postpartum [10% (11/115) vs. 64% (41/64), p<0.0001; adjusted relative risk=0.18, 95% confidence interval (0.10–0.34)]. Conclusions The significant decrease in nevirapine resistance conferred by one week of zidovudine+lamivudine should help policymakers optimize peripartum HIV prophylaxis recommendations. PMID:20672451

  19. Promotion of Cholera Awareness Among Households of Cholera Patients: A Randomized Controlled Trial of the Cholera-Hospital-Based-Intervention-for-7 Days (CHoBI7) Intervention.

    PubMed

    Saif-Ur-Rahman, K M; Parvin, Tahmina; Bhuyian, Sazzadul Islam; Zohura, Fatema; Begum, Farzana; Rashid, Mahamud-Ur; Biswas, Shwapon Kumar; Sack, David; Sack, R Bradley; Monira, Shirajum; Alam, Munirul; Shaly, Nusrat Jahan; George, Christine Marie

    2016-12-07

    Previous studies have demonstrated that household contacts of cholera patients are highly susceptible to cholera infections for a 7-day period after the presentation of the index patient in the hospital. However, there is no standard of care to prevent cholera transmission in this high-risk population. Furthermore, there is limited information available on awareness of cholera transmission and prevention among cholera patients and their household contacts. To initiate a standard of care for this high-risk population, we developed the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7), which delivers a handwashing with soap and water treatment intervention to household contacts during the time they spend with the admitted cholera patient in the hospital and reinforces these messages through home visits. To test CHoBI7, we conducted a randomized controlled trial among 302 intervention cholera patient household members and 302 control cholera patient household members in Dhaka, Bangladesh. In this study, we evaluated the effectiveness of the CHoBI7 intervention in increasing awareness of cholera transmission and prevention, and the key times for handwashing with soap. We observed a significant increase in cholera knowledge score in the intervention arm compared with the control arm at both the 1-week follow-up {score coefficient = 2.34 (95% confidence interval [CI] = 1.96, 2.71)} and 6 to 12-month follow-up period (score coefficient = 1.59 [95% CI = 1.05, 2.13]). This 1-week hospital- and home-based intervention led to a significant increase in knowledge of cholera transmission and prevention which was sustained 6 to 12 months post-intervention. These findings suggest that the CHoBI7 intervention presents a promising approach to increase cholera awareness among this high-risk population.

  20. Addition of 7 days of zidovudine plus lamivudine to peripartum single-dose nevirapine effectively reduces nevirapine resistance postpartum in HIV-infected mothers in Malawi.

    PubMed

    Farr, Sherry L; Nelson, Julie A E; Ng'ombe, Thokozani J; Kourtis, Athena P; Chasela, Charles; Johnson, Jeffrey A; Kashuba, Angela D M; Tegha, Gerald L; Wiener, Jeffrey; Eron, Joseph J; Banda, Harriet N; Mpaso, Mwanangwa; Lipscomb, Jonathan; Matiki, Chrissie; Fiscus, Susan A; Jamieson, Denise J; van der Horst, Charles

    2010-08-01

    We assessed whether 7 days of zidovudine + lamivudine postpartum with single-dose nevirapine at labor decreases nevirapine resistance in HIV-infected women in Malawi. HIV-infected pregnant women receiving intrapartum single-dose nevirapine and 7 days of zidovudine + lamivudine (n = 132) and women receiving intrapartum single-dose nevirapine alone (n = 66) were followed from an antenatal visit through 6 weeks postpartum. Plasma specimens at 2 and 6 weeks postpartum were tested for genotypic resistance to nevirapine by population sequencing and sensitive real-time polymerase chain reaction. Poisson regression was used to determine predictors of postpartum nevirapine resistance. Median HIV RNA was similar at entry (4.27 log vs. 4.35 log, P = 0.87), differed at 2 weeks postpartum (2.67 log vs. 3.58 log, P < 0.0001) but not at 6 weeks postpartum (4.49 log vs. 4.40 log, P = 0.79), between single-dose nevirapine/zidovudine + lamivudine and single-dose nevirapine groups, respectively. Nevirapine resistance, measured by population sequencing and sensitive real-time polymerase chain reaction, was significantly less common in those receiving single-dose nevirapine/zidovudine + lamivudine compared with single-dose nevirapine, respectively, at 2 weeks [10% (4 of 40) vs. 74% (31 of 42), P < 0.0001] and 6 weeks postpartum [10% (11 of 115) vs. 64% (41 of 64), P < 0.0001; adjusted relative risk = 0.18, 95% confidence interval (0.10 to 0.34)]. The significant decrease in nevirapine resistance conferred by 1 week of zidovudine + lamivudine should help policymakers optimize peripartum HIV prophylaxis recommendations.

  1. Optimal Length of Cultivation Time for Isolation of Propionibacterium acnes in Suspected Bone and Joint Infections Is More than 7 Days.

    PubMed

    Bossard, Daniel A; Ledergerber, Bruno; Zingg, Patrick O; Gerber, Christian; Zinkernagel, Annelies S; Zbinden, Reinhard; Achermann, Yvonne

    2016-12-01

    Diagnosis of Propionibacterium acnes bone and joint infection is challenging due to the long cultivation time of up to 14 days. We retrospectively studied whether reducing the cultivation time to 7 days allows accurate diagnosis without losing sensitivity. We identified patients with at least one positive P. acnes sample between 2005 and 2015 and grouped them into "infection" and "no infection." An infection was defined when at least two samples from the same case were positive. Clinical and microbiological data, including time to positivity for different cultivation methods, were recorded. We found 70 cases of proven P. acnes infection with a significant faster median time to positivity of 6 days (range, 2 to 11 days) compared to 9 days in 47 cases with P. acnes identified as a contamination (P < 0.0001). In 15 of 70 (21.4%) patients with an infection, tissue samples were positive after day 7 and in 6 patients (8.6%) after day 10 when a blind subculture of the thioglycolate broth was performed. The highest sensitivity was detected for thioglycolate broth (66.3%) and the best positive predictive values for anaerobic agar plates (96.5%). A prolonged transportation time from the operating theater to the microbiological laboratory did not influence time to positivity of P. acnes growth. By reducing the cultivation time to 7 days, false-negative diagnoses would increase by 21.4%; thus, we recommend that biopsy specimens from bone and joint infections be cultivated to detect P. acnes for 10 days with a blind subculture at the end. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  2. Optimal Length of Cultivation Time for Isolation of Propionibacterium acnes in Suspected Bone and Joint Infections Is More than 7 Days

    PubMed Central

    Bossard, Daniel A.; Ledergerber, Bruno; Zingg, Patrick O.; Gerber, Christian; Zinkernagel, Annelies S.; Zbinden, Reinhard

    2016-01-01

    Diagnosis of Propionibacterium acnes bone and joint infection is challenging due to the long cultivation time of up to 14 days. We retrospectively studied whether reducing the cultivation time to 7 days allows accurate diagnosis without losing sensitivity. We identified patients with at least one positive P. acnes sample between 2005 and 2015 and grouped them into “infection” and “no infection.” An infection was defined when at least two samples from the same case were positive. Clinical and microbiological data, including time to positivity for different cultivation methods, were recorded. We found 70 cases of proven P. acnes infection with a significant faster median time to positivity of 6 days (range, 2 to 11 days) compared to 9 days in 47 cases with P. acnes identified as a contamination (P < 0.0001). In 15 of 70 (21.4%) patients with an infection, tissue samples were positive after day 7 and in 6 patients (8.6%) after day 10 when a blind subculture of the thioglycolate broth was performed. The highest sensitivity was detected for thioglycolate broth (66.3%) and the best positive predictive values for anaerobic agar plates (96.5%). A prolonged transportation time from the operating theater to the microbiological laboratory did not influence time to positivity of P. acnes growth. By reducing the cultivation time to 7 days, false-negative diagnoses would increase by 21.4%; thus, we recommend that biopsy specimens from bone and joint infections be cultivated to detect P. acnes for 10 days with a blind subculture at the end. PMID:27733637

  3. Continuous 7-Days-A-Week External Beam Irradiation in Locally Advanced Cervical Cancer: Final Results of the Phase I/II Study

    SciTech Connect

    Serkies, Krystyna; Dziadziuszko, Rafal; Jassem, Jacek

    2012-03-01

    Purpose: To evaluate the feasibility and efficacy of definitive continuous 7-days-a-week pelvic irradiation without breaks between external beam radiotherapy and brachytherapy in locally advanced cervical cancer. Methods and Materials: Between November 1998 and December 1999, 30 patients with International Federation of Obstetrics and Gynecology Stage IIB or IIIB cervical cancer were included in a prospective Phase I/II study of continuous 7-days-a-week pelvic irradiation, to the total Manchester point B dose of 40.0-57.6 Gy. The first 13 patients (Group A) were given a daily tumor dose of 1.6 Gy, and the remaining 17 patients (Group B) were given 1.8 Gy. One or two immediate brachytherapy applications (point A dose 10-20 Gy, each) were performed in 28 cases. Results: Two patients did not complete the irradiation because of apparent early progression of disease during the irradiation. Eleven of the 28 evaluable patients (39%; 45% and 35% in Groups A and B, respectively) completed their treatment within the prescribed overall treatment time. Acute toxicity (including severe European Organisation for Research and Treatment of Cancer/Radiation Therapy Oncology Group Grade 3 and 4 effects in 40%) was experienced by 83% of patients and resulted in unplanned treatment interruptions in 40% of all patients (31% and 47% of patients in Groups A and B, respectively). Severe intestinal side effects occurred in 31% and 41% of Patients in Groups A and B, respectively (p = 0.71). The 5-year overall survival probability was 33%. Cancer recurrence occurred in 63% of patients: 20% inside and 57% outside the pelvis. Cumulative incidence of late severe bowel and urinary bladder toxicity at 24 months was 15%. Conclusion: Continuous irradiation in locally advanced cervical cancer is associated with a high incidence of severe acute toxicity, resulting in unplanned treatment interruptions. Late severe effects and survival after continuous radiotherapy do not substantially differ from

  4. A Randomized Controlled Trial of 7-Day Intensive and Standard Weekly Cognitive Therapy for PTSD and Emotion-Focused Supportive Therapy

    PubMed Central

    Ehlers, Anke; Hackmann, Ann; Grey, Nick; Wild, Jennifer; Liness, Sheena; Albert, Idit; Deale, Alicia; Stott, Richard; Clark, David M.

    2014-01-01

    Objective Psychological treatments for posttraumatic stress disorder (PTSD) are usually delivered once or twice weekly over several months. It is unclear whether they can be successfully delivered over a shorter period of time. This clinical trial had two goals, (1) to investigate the acceptability and efficacy of a 7-day intensive version of cognitive therapy for PTSD, and (2) to investigate whether cognitive therapy has specific treatment effects by comparing intensive and standard weekly cognitive therapy with an equally credible alternative treatment. Method Patients with chronic PTSD (N=121) were randomly allocated to 7-day intensive or standard 3-month weekly cognitive therapy for PTSD, 3-month weekly emotion-focused supportive therapy, or a 14-week waitlist condition. Primary outcomes were PTSD symptoms and diagnosis as assessed by independent assessors and self-report. Secondary outcomes were disability, anxiety, depression, and quality of life. Measures were taken at initial assessment, 6 weeks and 14 weeks (post-treatment/wait). For groups receiving treatment, measures were also taken at 3 weeks, and follow-ups at 27 and 40 weeks after randomization. All analyses were intent-to-treat. Results At post-treatment/wait assessment, 73%, 77%, 43%, 7% of the intensive cognitive therapy, standard cognitive therapy, supportive therapy, and waitlist groups, respectively, had recovered from PTSD. All treatments were well tolerated and were superior to waitlist on all outcome measures, with the exception of no difference between supportive therapy and waitlist on quality of life. For primary outcomes, disability and general anxiety, intensive and standard cognitive therapy were superior to supportive therapy. Intensive cognitive therapy achieved faster symptom reduction and comparable overall outcomes to standard cognitive therapy. Conclusions Cognitive therapy for PTSD delivered intensively over little more than a week is as effective as cognitive therapy delivered

  5. Effects of 7-day repeated treatment with the 5-HT2A inverse agonist/antagonist pimavanserin on methamphetamine vs. food choice in male rhesus monkeys.

    PubMed

    Banks, Matthew L

    2016-08-01

    Preclinical drug vs. food choice is an emerging group of drug self-administration procedures that have shown predictive validity to clinical drug addiction. Emerging data suggest that serotonin (5-HT)2A receptors modulate mesolimbic dopamine function, such that 5-HT2A antagonists blunt the abuse-related neurochemical effects of monoamine transporter substrates, such as amphetamine or methamphetamine. Whether subchronic 5-HT2A antagonist treatment attenuates methamphetamine reinforcement in any preclinical drug self-administration procedure is unknown. The study aim was therefore to determine 7-day treatment effects with the 5-HT2A inverse agonist/antagonist pimavanserin on methamphetamine vs. food choice in monkeys. Behavior was maintained under a concurrent schedule of food delivery (1g pellets, fixed-ratio 100 schedule) and intravenous methamphetamine injections (0-0.32 mg/kg/injection, fixed-ratio 10 schedule) in male rhesus monkeys (n=3). Methamphetamine choice dose-effect functions were determined daily before and during 7-day repeated pimavanserin (1.0-10mg/kg/day, intramuscular) treatment periods. Under control conditions, increasing methamphetamine doses resulted in a corresponding increase in methamphetamine vs. food choice. Repeated pimavanserin administration failed to attenuate methamphetamine choice and produce a reciprocal increase in food choice in any monkey up to doses (3.2-10mg/kg) that suppressed rates of operant responding primarily during components where behavior was maintained by food pellets. Repeated 5-HT2A receptor inverse agonist/antagonist treatment did not attenuate methamphetamine reinforcement under a concurrent schedule of intravenous methamphetamine and food presentation in nonhuman primates. Overall, these results do not support the therapeutic potential of 5-HT2A inverse agonists/antagonists as candidate medications for methamphetamine addiction. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights

  6. [Nasopharyngeal myiasis during mechanical ventilation].

    PubMed

    Yoshitomi, A; Sato, A; Suda, T; Chida, K

    1997-12-01

    We report a case of myiasis caused by Phaenicia sericata during mechanical ventilation. An 86-year-old woman with bronchiectasis was admitted to our hospital with severe respiratory failure. Treatment with mechanical ventilation and sedatives was initiated. On the 10th day of hospitalization, about 20 white larvae were found in the patient's oral or nasal cavities. The larvae were removed and identified as Phaenicia sericata. No mucosal injury was found in the patient's oral or nasal cavity by endoscopic examination. The patient died of multiple organ failure caused by sepsis that had no association with myiasis. From the clinical course and the fly's life cycle, it is considered that the fly laid eggs in the patient's oral or nasal cavity while she was sedated during mechanical ventilation. Myiasis can occur even in a hospital.

  7. Assisted mechanical ventilation: the future is now!

    PubMed

    Kacmarek, Robert M; Pirrone, Massimiliano; Berra, Lorenzo

    2015-07-29

    Assisted ventilation is a highly complex process that requires an intimate interaction between the ventilator and the patient. The complexity of this form of ventilation is frequently underappreciated by the bedside clinician. In assisted mechanical ventilation, regardless of the specific mode, the ventilator's gas delivery pattern and the patient's breathing pattern must match near perfectly or asynchrony between the patient and the ventilator occurs. Asynchrony can be categorized into four general types: flow asynchrony; trigger asynchrony; cycle asynchrony; and mode asynchrony. In an article recently published in BMC Anesthesiology, Hodane et al. have demonstrated reduced asynchrony during assisted ventilation with Neurally Adjusted Ventilatory Assist (NAVA) as compared to pressure support ventilation (PSV). These findings add to the growing volume of data indicating that modes of ventilation that provide proportional assistance to ventilation - e.g., NAVA and Proportional Assist Ventilation (PAV) - markedly reduce asynchrony. As it becomes more accepted that the respiratory center of the patient in most circumstances is the most appropriate determinant of ventilatory pattern and as the negative outcome effects of patient-ventilator asynchrony become ever more recognized, we can expect NAVA and PAV to become the preferred modes of assisted ventilation!

  8. [Pressure support ventilation and proportional assist ventilation during weaning from mechanical ventilation].

    PubMed

    Aguirre-Bermeo, H; Bottiroli, M; Italiano, S; Roche-Campo, F; Santos, J A; Alonso, M; Mancebo, J

    2014-01-01

    To compare tolerance, duration of mechanical ventilation (MV) and clinical outcomes during weaning from MV in patients subjected to either pressure support ventilation (PSV) or proportional assist ventilation (PAV). A prospective, observational study was carried out. Intensive Care Unit. A total of 40 consecutive subjects were allocated to either the PSV or the PAV group until each group contained 20 patients. Patients were included in the study when they met the criteria to begin weaning and the attending physician decided to initiate the weaning process. The physician selected the modality and set the ventilatory parameters. None. Demographic data, respiratory mechanics, ventilatory parameters, duration of MV, and clinical outcomes (reintubation, tracheostomy, mortality). Baseline characteristics were similar in both groups. No significant differences were observed between the PSV and PAV groups in terms of the total duration of MV (10 [5-18] vs. 9 [7-19] days; P=.85), reintubation (5 [31%] vs. 3 [19%]; P=.69), or mortality (4 [20%] vs. 5 [25%] deaths; P=1). Eight patients (40%) in the PSV group and 6 patients (30%) in the PAV group (P=.74) required a return to volume assist-control ventilation due to clinical deterioration. Tolerance, duration of MV and clinical outcomes during weaning from mechanical ventilation were similar in PSV and PAV. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  9. FLOW-i ventilator performance in the presence of a circle system leak.

    PubMed

    Lucangelo, Umberto; Ajčević, Miloš; Accardo, Agostino; Borelli, Massimo; Peratoner, Alberto; Comuzzi, Lucia; Zin, Walter A

    2017-04-01

    Recently, the FLOW-i anaesthesia ventilator was developed based on the SERVO-i intensive care ventilator. The aim of this study was to test the FLOW-i's tidal volume delivery in the presence of a leak in the breathing circuit. We ventilated a test lung model in volume-, pressure-, and pressure-regulated volume-controlled modes (VC, PC, and PRVC, respectively) with a FLOW-i. First, the circuit remained airtight and the ventilator was tested with fresh gas flows of 6, 1, and 0.3 L/min in VC, PC, and PRVC modes and facing 4 combinations of different resistive and elastic loads. Second, a fixed leak in the breathing circuit was introduced and the measurements repeated. In the airtight system, FLOW-i maintained tidal volume (VT) and circuit pressure at approximately the set values, independently of respiratory mode, load, or fresh gas flow. In the leaking circuit, set VT = 500 mL, FLOW-i delivered higher VTs in PC (about 460 mL) than in VC and PRVC, where VTs were substantially less than 500 mL. Interestingly, VT did not differ appreciably from 6 to 0.3 L/min of fresh air flow among the 3 ventilatory modes. In the absence of leakage, peak inspiratory pressures were similar, while they were 35-45 % smaller in PRVC and VC than in PC mode in the presence of leaks. In conclusion, FLOW-i maintained VT (down to fresh gas flows of 0.3 L/min) to 90 % of its preset value in PC mode, which was 4-5 times greater than in VC or PRVC modes.

  10. Human versus Computer Controlled Selection of Ventilator Settings: An Evaluation of Adaptive Support Ventilation and Mid-Frequency Ventilation.

    PubMed

    Mireles-Cabodevila, Eduardo; Diaz-Guzman, Enrique; Arroliga, Alejandro C; Chatburn, Robert L

    2012-01-01

    Background. There are modes of mechanical ventilation that can select ventilator settings with computer controlled algorithms (targeting schemes). Two examples are adaptive support ventilation (ASV) and mid-frequency ventilation (MFV). We studied how different clinician-chosen ventilator settings are from these computer algorithms under different scenarios. Methods. A survey of critical care clinicians provided reference ventilator settings for a 70 kg paralyzed patient in five clinical/physiological scenarios. The survey-derived values for minute ventilation and minute alveolar ventilation were used as goals for ASV and MFV, respectively. A lung simulator programmed with each scenario's respiratory system characteristics was ventilated using the clinician, ASV, and MFV settings. Results. Tidal volumes ranged from 6.1 to 8.3 mL/kg for the clinician, 6.7 to 11.9 mL/kg for ASV, and 3.5 to 9.9 mL/kg for MFV. Inspiratory pressures were lower for ASV and MFV. Clinician-selected tidal volumes were similar to the ASV settings for all scenarios except for asthma, in which the tidal volumes were larger for ASV and MFV. MFV delivered the same alveolar minute ventilation with higher end expiratory and lower end inspiratory volumes. Conclusions. There are differences and similarities among initial ventilator settings selected by humans and computers for various clinical scenarios. The ventilation outcomes are the result of the lung physiological characteristics and their interaction with the targeting scheme.

  11. Bacterial and viral contamination of breathing circuits after extended use - an aspect of patient safety?

    PubMed

    Dubler, S; Zimmermann, S; Fischer, M; Schnitzler, P; Bruckner, T; Weigand, M A; Frank, U; Hofer, S; Heininger, A

    2016-10-01

    In the past, anaesthetic breathing circuits were identified as a source of pathogen transmission. It is still debated, whether breathing circuits combined with breathing system filters can be safely used for more than 1 day. The aim of this study was to evaluate the transmission risk of bacteria and also viruses via breathing circuits after extended use. The inner and outer surface of 102 breathing circuits used for 1 day and of 101 circuits used for 7 days were examined for bacteria and viruses. Additionally, 10 and 20 breathing circuits each were examined after use on patients with pulmonary virus infection and with multidrug-resistant organism (MDRO) colonisation/infection respectively. Bacteria were detected by standard microbiological procedures; PCR techniques were applied for herpes simplex virus, cytomegalovirus, influenza, parainfluenza and respiratory syncytial virus. Endoluminal bacterial contamination of breathing circuits remained unchanged after 7-day vs. 1-day use (5.9% vs. 7.8%) [CI95%: -0.0886-0.0506, pnon-inferiority 0.0260]. Only outside surface contamination with bacteria belonging to environmental species or human flora increased (16.8 vs. 6.9%) [CI 95%: 0.0118 - 0.1876, pnon-inferiority 0.8660]. Viruses occurred on the patient side, but not in breathing circuits. No MDRO occurred in the 20 circuits after use on patients harbouring such germs. Endoluminal contamination of breathing circuits with bacteria did not increase after extended use. No viruses were detected in the breathing circuits using filters. Based on our results, the extended use of ABC without exceptions appears safe, if a high level of anaesthesia workplace cleaning is secured. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  12. Dielectric Circuit Board Bonding.

    DTIC Science & Technology

    circuit boards to form subassemblies and the bonding of subassemblies together. The finished circuit may include a bonded-in ground plate of copper...The patent application describes a method and apparatus for bonding of dielectric circuit boards for microwave use, the bonding together of several...wire cloth or the like and may include through- plate holes. The technique includes the build-up of thin films to provide strength, toughness and

  13. Remote reset circuit

    DOEpatents

    Gritzo, R.E.

    1985-09-12

    A remote reset circuit acts as a stand-along monitor and controller by clocking in each character sent by a terminal to a computer and comparing it to a given reference character. When a match occurs, the remote reset circuit activates the system's hardware reset line. The remote reset circuit is hardware based centered around monostable multivibrators and is unaffected by system crashes, partial serial transmissions, or power supply transients. 4 figs.

  14. Regenerative feedback resonant circuit

    DOEpatents

    Jones, A. Mark; Kelly, James F.; McCloy, John S.; McMakin, Douglas L.

    2014-09-02

    A regenerative feedback resonant circuit for measuring a transient response in a loop is disclosed. The circuit includes an amplifier for generating a signal in the loop. The circuit further includes a resonator having a resonant cavity and a material located within the cavity. The signal sent into the resonator produces a resonant frequency. A variation of the resonant frequency due to perturbations in electromagnetic properties of the material is measured.

  15. Remote reset circuit

    DOEpatents

    Gritzo, Russell E.

    1987-01-01

    A remote reset circuit acts as a stand-alone monitor and controller by clocking in each character sent by a terminal to a computer and comparing it to a given reference character. When a match occurs, the remote reset circuit activates the system's hardware reset line. The remote reset circuit is hardware based centered around monostable multivibrators and is unaffected by system crashes, partial serial transmissions, or power supply transients.

  16. Automatic circuit interrupter

    NASA Technical Reports Server (NTRS)

    Dwinell, W. S.

    1979-01-01

    In technique, voice circuits connecting crew's cabin to launch station through umbilical connector disconnect automatically unused, or deadened portion of circuits immediately after vehicle is launched, eliminating possibility that unused wiring interferes with voice communications inside vehicle or need for manual cutoff switch and its associated wiring. Technique is applied to other types of electrical actuation circuits, also launch of mapped vehicles, such as balloons, submarines, test sleds, and test chambers-all requiring assistance of ground crew.

  17. Intraoperative mechanical ventilation for the pediatric patient.

    PubMed

    Kneyber, Martin C J

    2015-09-01

    Invasive mechanical ventilation is required when children undergo general anesthesia for any procedure. It is remarkable that one of the most practiced interventions such as pediatric mechanical ventilation is hardly supported by any scientific evidence but rather based on personal experience and data from adults, especially as ventilation itself is increasingly recognized as a harmful intervention that causes ventilator-induced lung injury. The use of low tidal volume and higher levels of positive end-expiratory pressure became an integral part of lung-protective ventilation following the outcomes of clinical trials in critically ill adults. This approach has been readily adopted in pediatric ventilation. However, a clear association between tidal volume and mortality has not been ascertained in pediatrics. In fact, experimental studies have suggested that young children might be less susceptible to ventilator-induced lung injury. As such, no recommendations on optimal lung-protective ventilation strategy in children with or without lung injury can be made.

  18. The School Advanced Ventilation Engineering Software (SAVES)

    EPA Pesticide Factsheets

    The School Advanced Ventilation Engineering Software (SAVES) package is a tool to help school designers assess the potential financial payback and indoor humidity control benefits of Energy Recovery Ventilation (ERV) systems for school applications.

  19. [PhysioFlex: a target-controlled self-regulating closed-circuit inhalation anesthesia regulator].

    PubMed

    Nathan, N; Sperandio, M; Erdmann, W; Westerkamp, B; Van Dijk, G; Scherpereel, P; Feiss, P

    1997-01-01

    Physi Flex is the first commercially available apparatus capable for quantitative, or self-regulating target controlled inhalational anaesthesia, with a totally closed circuit, in adults and children. The fresh gas supply to the circuit is intermittent, automatically regulated by continuous monitoring of the volume and composition of the gas mixture in the breathing circuit. The circle system includes, instead of the two conventional one way valves, a blower creating a continuous unidirectional flow at 70 L.min-1. In addition to the CO2-absorber it contains an absorber with carbon, absorbing the anaesthetic vapour when switched into the circuit. The ventilator consists of four ventilating chambers, each one with a membrane separating the patient and the motor compartments. The displacement of the membranes generates and measures the tidal volume. Automatic ventilation is achieved by electric valves and motor gas, and manual ventilation using a bag. Spontaneous ventilation is also possible. The machine is operated via a computer with selects the number of ventilating chambers (one, two or four), and the tidal volume between 50 and 2,000 mL, depending on age, gender and weight of the patient. The computer maintains the gas volume and the gas and vapour concentrations at their preset values. The O2-flow and consumption, the N2O flow and uptake, FICO2 and FETCO2, FI and FET of the volatile anaesthetic, all other important data are displayed in a numerical and graphical form on a color screen and registered for a delayed analysis. The end tidal concentration of the volatile anaesthetic drives a stepmotor with a syringe containing the selected volatile anaesthetic agent with is directly injected into the breathing circuit where it is vaporized. Therefore the concentration of the anaesthetic vapour can be instantaneously increased with this injector at induction and lowered at end of anaesthesia with the carbon absorber, and the fresh gas consumption is significantly

  20. Printed circuit board industry.

    PubMed

    LaDou, Joseph

    2006-05-01

    The printed circuit board is the platform upon which microelectronic components such as semiconductor chips and capacitors are mounted. It provides the electrical interconnections between components and is found in virtually all electronics products. Once considered low technology, the printed circuit board is evolving into a high-technology product. Printed circuit board manufacturing is highly complicated, requiring large equipment investments and over 50 process steps. Many of the high-speed, miniaturized printed circuit boards are now manufactured in cleanrooms with the same health and safety problems posed by other microelectronics manufacturing. Asia produces three-fourths of the world's printed circuit boards. In Asian countries, glycol ethers are the major solvents used in the printed circuit board industry. Large quantities of hazardous chemicals such as formaldehyde, dimethylformamide, and lead are used by the printed circuit board industry. For decades, chemically intensive and often sloppy manufacturing processes exposed tens of thousands of workers to a large number of chemicals that are now known to be reproductive toxicants and carcinogens. The printed circuit board industry has exposed workers to high doses of toxic metals, solvents, acids, and photolithographic chemicals. Only recently has there been any serious effort to diminish the quantity of lead distributed worldwide by the printed circuit board industry. Billions of electronics products have been discarded in every region of the world. This paper summarizes recent regulatory and enforcement efforts.

  1. Fast Overcurrent Tripping Circuit

    NASA Technical Reports Server (NTRS)

    Sullender, Craig C.; Davies, Bryan L.; Osborn, Stephen H.

    1993-01-01

    Fast overcurrent tripping circuit designed for incorporation into power metal oxide/semiconductor field-effect transistor (MOSFET) switching circuit. Serves as fast electronic circuit breaker by sensing voltage across MOSFET's during conduction and switching MOSFET's off within 1 microsecond after voltage exceeds reference value corresponding to tripping current. Acts more quickly than Hall-effect current sensor and, in comparison with shunt current-measuring circuits, smaller and consumes less power. Also ignores initial transient overcurrents during first 5 microseconds of switching cycle.

  2. The effect of changing ventilator settings on indices of ventilation inhomogeneity in small ventilated lungs

    PubMed Central

    Schmalisch, G; Proquitté, H; Roehr, CC; Wauer, RR

    2006-01-01

    Background In ventilated newborns the use of multiple breath washout (MBW) techniques for measuring both lung volume and ventilation inhomogeneity (VI) is hampered by the comparatively high dead space fraction. We studied how changes in ventilator settings affected VI indices in this particular population. Methods Using a computer simulation of a uniformly ventilated volume the interaction between VI indices (lung clearance index (LCI), moment ratios (M1/M0, M2/M0, AMDN1, AMDN2) of the washout curve) and tidal volume (VT), dead space (VD) and functional residual capacity (FRC) were calculated. The theoretical results were compared with measurements in 15 ventilated piglets (age <12 h, median weight 1135 g) by increasing the peak inspiratory pressure (PIP). FRC and VI indices were measured by MBW using 0.8% heptafluoropropane as tracer gas. Results The computer simulation showed that the sensitivity of most VI indices to changes in VD/VT and VT/FRC increase, in particular for VD/VT > 0.5. In piglets, the raised PIP caused a significant increase of VT from 15.4 ± 9.5 to 21.9 ± 14.7 (p = 0.003) and of the FRC from 31.6 ± 14.7 mL to 35.0 ± 15.9 mL (p = 0.006), whereas LCI (9.15 ± 0.75 to 8.55 ± 0.74, p = 0.019) and the moment ratios M1/M0, M2/M0 (p < 0.02) decreased significantly. No significant changes were seen in AMDN1 and AMDN2. The within-subject variability of the VI indices (coefficient of variation in brackets) was distinctly higher (LCI (9.8%), M1/M0 (6.6%), M2/M0 (14.6%), AMDN1 (9.1%), AMDN2 (16.3%)) compared to FRC measurements (5.6%). Computer simulations showed that significant changes in VI indices were exclusively caused by changes in VT and FRC and not by an improvement of the homogeneity of alveolar ventilation. Conclusion In small ventilated lungs with a high dead space fraction, indices of VI may be misinterpreted if the changes in ventilator settings are not considered. Computer simulations can help to prevent this misinterpretation. PMID

  3. Inadequate face mask ventilation--clinical applications.

    PubMed

    Goranović, Tatjana; Milić, Morena; Holjevac, Jadranka Katancić; Maldini, Branka; Sakić, Katarina

    2010-09-01

    Face mask ventilation is a life saving technique. This article will review aetiology and patophysiological consequences of inadequate mask ventilation. The main focus will be on circulatory changes during induction of anesthesia, before and in a short period after intubation that could be attributed to inadequate mask ventilation in humans.

  4. 30 CFR 57.8520 - Ventilation plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... system; (4) Locations of all main, booster and auxiliary fans not shown in paragraph (d) of this standard...) Significant changes in the ventilation system projected for one year. (c) Mine fan data for all active main... Underground Only § 57.8520 Ventilation plan. A plan of the mine ventilation system shall be set out by the...

  5. 14 CFR 27.831 - Ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 27.831 Ventilation. (a) The ventilating system for the pilot and passenger compartments must be designed to prevent... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Ventilation. 27.831 Section...

  6. 14 CFR 27.831 - Ventilation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 27.831 Ventilation. (a) The ventilating system for the pilot and passenger compartments must be designed to prevent... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Ventilation. 27.831 Section...

  7. 14 CFR 27.831 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 27.831 Ventilation. (a) The ventilating system for the pilot and passenger compartments must be designed to prevent... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Ventilation. 27.831 Section...

  8. 14 CFR 27.831 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 27.831 Ventilation. (a) The ventilating system for the pilot and passenger compartments must be designed to prevent... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Ventilation. 27.831 Section...

  9. 46 CFR 194.15-5 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Ventilation of air conditioning systems serving the chemical laboratory shall be designed so that air cannot... 46 Shipping 7 2012-10-01 2012-10-01 false Ventilation. 194.15-5 Section 194.15-5 Shipping COAST....15-5 Ventilation. (a) Operations, reactions or experiments which produce toxic, noxious or...

  10. 14 CFR 27.831 - Ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STANDARDS: NORMAL CATEGORY ROTORCRAFT Design and Construction Personnel and Cargo Accommodations § 27.831 Ventilation. (a) The ventilating system for the pilot and passenger compartments must be designed to prevent... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Ventilation. 27.831 Section...

  11. 46 CFR 194.15-5 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Ventilation of air conditioning systems serving the chemical laboratory shall be designed so that air cannot... 46 Shipping 7 2011-10-01 2011-10-01 false Ventilation. 194.15-5 Section 194.15-5 Shipping COAST....15-5 Ventilation. (a) Operations, reactions or experiments which produce toxic, noxious or...

  12. 46 CFR 111.15-10 - Ventilation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

  13. 46 CFR 116.610 - Ventilation ducts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... type of piping, chamber, or conduit used for ventilation. (b) A ventilation duct, and materials incidental to its installation, must be made of noncombustible material. (c) Combustibles and other foreign materials are not allowed within ventilation ducts. However, metal piping and electrical wiring installed in...

  14. 46 CFR 111.15-10 - Ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

  15. 46 CFR 111.15-10 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

  16. 46 CFR 111.15-10 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

  17. 46 CFR 111.15-10 - Ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... REQUIREMENTS Storage Batteries and Battery Chargers: Construction and Installation § 111.15-10 Ventilation. (a) General. Each room, locker, and box for storage batteries must be arranged or ventilated to prevent... with the battery charger so that the battery cannot be charged without ventilation. (c) Large battery...

  18. 14 CFR 125.117 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Ventilation. 125.117 Section 125.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS....117 Ventilation. Each passenger or crew compartment must be suitably ventilated. Carbon...

  19. 14 CFR 125.117 - Ventilation.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Ventilation. 125.117 Section 125.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS....117 Ventilation. Each passenger or crew compartment must be suitably ventilated. Carbon...

  20. 9 CFR 91.21 - Ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Ventilation. 91.21 Section 91.21... LIVESTOCK FOR EXPORTATION Inspection of Vessels and Accommodations § 91.21 Ventilation. Each underdeck... mechanical ventilation that will furnish a complete change of air in each compartment every 2 minutes...

  1. 14 CFR 125.117 - Ventilation.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Ventilation. 125.117 Section 125.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS....117 Ventilation. Each passenger or crew compartment must be suitably ventilated. Carbon...

  2. 14 CFR 125.117 - Ventilation.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Ventilation. 125.117 Section 125.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS....117 Ventilation. Each passenger or crew compartment must be suitably ventilated. Carbon...

  3. 33 CFR 175.201 - Ventilation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Ventilation. 175.201 Section 175.201 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Ventilation § 175.201 Ventilation. No person may operate a boat built...

  4. 14 CFR 125.117 - Ventilation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Ventilation. 125.117 Section 125.117 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS....117 Ventilation. Each passenger or crew compartment must be suitably ventilated. Carbon...

  5. 33 CFR 175.201 - Ventilation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Ventilation. 175.201 Section 175... SAFETY EQUIPMENT REQUIREMENTS Ventilation § 175.201 Ventilation. No person may operate a boat built after July 31, 1980, that has a gasoline engine for electrical generation, mechanical power, or...

  6. 46 CFR 153.312 - Ventilation system standards.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ventilation system must be sized to change the air in the ventilated space at least 30 times per hour. (f) A... Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space ventilation... (approx. 32.8 ft) from openings into or ventilation intakes for, accommodation or service spaces. (b) A...

  7. Fire Service Training. Ventilation. (Revised).

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Community Colleges, Raleigh.

    One of a set of fourteen outlines for use in a course to train novice firemen, this guide covers ventilation practices and principles. As background, subjects such as heat transmission and building construction are included. The three objectives of this part of the course are to enable the fireman to (1) rescue trapped victims, (2) locate fires as…

  8. Preventing Ventilation On Sailboard Skegs

    NASA Technical Reports Server (NTRS)

    Caldwell, Richard A.

    1990-01-01

    Design effort undertaken to solve spinout problem plaguing high-performance sailboards. Proposed skeg section designed by use of computer model of pressure field and boundary layer. Prevents ventilation by maintaining attached boundary-layer flow throughout operating environment. Cavitation also avoided by preventing valleys in pressure distribution while skeg operated throughout its range.

  9. Preventing Ventilation On Sailboard Skegs

    NASA Technical Reports Server (NTRS)

    Caldwell, Richard A.

    1990-01-01

    Design effort undertaken to solve spinout problem plaguing high-performance sailboards. Proposed skeg section designed by use of computer model of pressure field and boundary layer. Prevents ventilation by maintaining attached boundary-layer flow throughout operating environment. Cavitation also avoided by preventing valleys in pressure distribution while skeg operated throughout its range.

  10. Prognosis of mechanically ventilated patients.

    PubMed Central

    Papadakis, M A; Lee, K K; Browner, W S; Kent, D L; Matchar, D B; Kagawa, M K; Hallenbeck, J; Lee, D; Onishi, R; Charles, G

    1993-01-01

    In this Department of Veterans Affairs cooperative study, we examined predictors of in-hospital and 1-year mortality of 612 mechanically ventilated patients from 6 medical intensive care units in a retrospective cohort design. The outcome variable was vital status at hospital discharge and after 1 year. The results showed that 97% of patients were men, the mean age was 63 +/- 11 years (SD), and hospital mortality was 64% (95% confidence interval, 60% to 68%). Within the next year, an additional 38% of hospital survivors died, for a total 1-year mortality of 77% (95% confidence interval, 73% to 80%). Hospital and 1-year mortality, respectively, for patients older than 70 years was 76% and 94%, for those with serum albumin levels below 20 grams per liter it was 92% and 96%, for those with an Acute Physiology and Chronic Health Evaluation II (APACHE II) score greater than 35 it was 91% and 98%, and for patients who were being mechanically ventilated after cardiopulmonary resuscitation it was 86% and 90%. The mortality ratio (actual mortality versus APACHE II-predicted mortality) was 1.15. Conclusions are that patient age, APACHE II score, serum albumin levels, or the use of cardiopulmonary resuscitation may identify a subset of mechanically ventilated veterans for whom mechanical ventilation provides little or no benefit. PMID:8128673

  11. Increased blood-brain barrier permeability in mammalian brain 7 days after exposure to the radiation from a GSM-900 mobile phone.

    PubMed

    Nittby, Henrietta; Brun, Arne; Eberhardt, Jacob; Malmgren, Lars; Persson, Bertil R R; Salford, Leif G

    2009-08-01

    Microwaves were for the first time produced by humans in 1886 when radio waves were broadcasted and received. Until then microwaves had only existed as a part of the cosmic background radiation since the birth of universe. By the following utilization of microwaves in telegraph communication, radars, television and above all, in the modern mobile phone technology, mankind is today exposed to microwaves at a level up to 10(20) times the original background radiation since the birth of universe. Our group has earlier shown that the electromagnetic radiation emitted by mobile phones alters the permeability of the blood-brain barrier (BBB), resulting in albumin extravasation immediately and 14 days after 2h of exposure. In the background section of this report, we present a thorough review of the literature on the demonstrated effects (or lack of effects) of microwave exposure upon the BBB. Furthermore, we have continued our own studies by investigating the effects of GSM mobile phone radiation upon the blood-brain barrier permeability of rats 7 days after one occasion of 2h of exposure. Forty-eight rats were exposed in TEM-cells for 2h at non-thermal specific absorption rates (SARs) of 0mW/kg, 0.12mW/kg, 1.2mW/kg, 12mW/kg and 120mW/kg. Albumin extravasation over the BBB, neuronal albumin uptake and neuronal damage were assessed. Albumin extravasation was enhanced in the mobile phone exposed rats as compared to sham controls after this 7-day recovery period (Fisher's exact probability test, p=0.04 and Kruskal-Wallis, p=0.012), at the SAR-value of 12mW/kg (Mann-Whitney, p=0.007) and with a trend of increased albumin extravasation also at the SAR-values of 0.12mW/kg and 120mW/kg. There was a low, but significant correlation between the exposure level (SAR-value) and occurrence of focal albumin extravasation (r(s)=0.33; p=0.04). The present findings are in agreement with our earlier studies where we have seen increased BBB permeability immediately and 14 days after

  12. Liquid detection circuit

    DOEpatents

    Regan, Thomas O.

    1987-01-01

    Herein is a circuit which is capable of detecting the presence of liquids, especially cryogenic liquids, and whose sensor will not overheat in a vacuum. The circuit parameters, however, can be adjusted to work with any liquid over a wide range of temperatures.

  13. Completing a Simple Circuit.

    ERIC Educational Resources Information Center

    Slater, Timothy F.; Adams, Jeffrey P.; Brown, Thomas R.

    2000-01-01

    Students have problems successfully arranging an electric circuit to make the bulb produce light. Investigates the percentage of students able to complete a circuit with a given apparatus, and the effects of prior experience on student success. Recommends hands-on activities at the elementary and secondary school levels. (Contains 14 references.)…

  14. Understanding Simple Circuits

    ERIC Educational Resources Information Center

    Mant, Jenny; Wilson, Helen

    2007-01-01

    Many envisage electricity as the "power" to "do things." They know that electricity needs "circuits" and that something is "flowing" in the circuits, but they are not sure what or why. Words such as "current" and "voltage" are part of electricity but their meaning, and the difference between them, is not always clear. In this article, the authors…

  15. A Virtual Circuits Lab

    ERIC Educational Resources Information Center

    Vick, Matthew E.

    2010-01-01

    The University of Colorado's Physics Education Technology (PhET) website offers free, high-quality simulations of many physics experiments that can be used in the classroom. The Circuit Construction Kit, for example, allows students to safely and constructively play with circuit components while learning the mathematics behind many circuit…

  16. Electroshock protection circuit

    NASA Technical Reports Server (NTRS)

    Heskett, H.; Meincer, J.; Inglis, A. L.

    1973-01-01

    Circuit was developed to prevent accidental shock through electrodes used to test subjects as part of Skylab program. This circuit is placed between electrical apparatus and electrode that is attached to patient's body. Thus, patient is effectively protected from dangerous electrical shock that might be caused by failure in electrical apparatus.

  17. Understanding Simple Circuits

    ERIC Educational Resources Information Center

    Mant, Jenny; Wilson, Helen

    2007-01-01

    Many envisage electricity as the "power" to "do things." They know that electricity needs "circuits" and that something is "flowing" in the circuits, but they are not sure what or why. Words such as "current" and "voltage" are part of electricity but their meaning, and the difference between them, is not always clear. In this article, the authors…

  18. A Virtual Circuits Lab

    ERIC Educational Resources Information Center

    Vick, Matthew E.

    2010-01-01

    The University of Colorado's Physics Education Technology (PhET) website offers free, high-quality simulations of many physics experiments that can be used in the classroom. The Circuit Construction Kit, for example, allows students to safely and constructively play with circuit components while learning the mathematics behind many circuit…

  19. Genetic circuit design automation.

    PubMed

    Nielsen, Alec A K; Der, Bryan S; Shin, Jonghyeon; Vaidyanathan, Prashant; Paralanov, Vanya; Strychalski, Elizabeth A; Ross, David; Densmore, Douglas; Voigt, Christopher A

    2016-04-01

    Computation can be performed in living cells by DNA-encoded circuits that process sensory information and control biological functions. Their construction is time-intensive, requiring manual part assembly and balancing of regulator expression. We describe a design environment, Cello, in which a user writes Verilog code that is automatically transformed into a DNA sequence. Algorithms build a circuit diagram, assign and connect gates, and simulate performance. Reliable circuit design requires the insulation of gates from genetic context, so that they function identically when used in different circuits. We used Cello to design 60 circuits forEscherichia coli(880,000 base pairs of DNA), for which each DNA sequence was built as predicted by the software with no additional tuning. Of these, 45 circuits performed correctly in every output state (up to 10 regulators and 55 parts), and across all circuits 92% of the output states functioned as predicted. Design automation simplifies the incorporation of genetic circuits into biotechnology projects that require decision-making, control, sensing, or spatial organization. Copyright © 2016, American Association for the Advancement of Science.

  20. Computer circuit card puller

    NASA Technical Reports Server (NTRS)

    Sawyer, R. V.; Szuwalski, B. (Inventor)

    1981-01-01

    The invention generally relates to hand tools, and more particularly to an improved device for facilitating removal of printed circuit cards from a card rack characterized by longitudinal side rails arranged in a mutually spaced parallelism and a plurality of printed circuit cards extended between the rails of the rack.

  1. Integrated Optical Circuits

    DTIC Science & Technology

    1974-06-30

    with discrete EAP detectors, the electroabsorption effect is particularly promising for integrated waveguide photodetectors and modulators. High...IR-75-103 lloJM. ± Semiannual Technical Summary Integrated Optical Circuits 30 June 1974 Prepared for the Advanced Research Projects Agency und...needed. MASSACHUSETTS INSTITUTE OF TECHNOLOGY LINCOLN LABORATORY INTEGRATED OPTICAL CIRCUITS SEMIANNUAL TECHNICAL SUMMARY REPORT TO THE

  2. Catheter transducer and circuit

    NASA Technical Reports Server (NTRS)

    Harrison, D. R.; Kerwin, W. J.

    1971-01-01

    Simple integrated circuit located at transducer, enables use of single coaxial cable for both input and output connections. Circuit is sensitive to changes in RC time constant, has much improved sensitivity characteristics, and is unaffected by changes in cable capacitance effects.

  3. Completing a Simple Circuit.

    ERIC Educational Resources Information Center

    Slater, Timothy F.; Adams, Jeffrey P.; Brown, Thomas R.

    2000-01-01

    Students have problems successfully arranging an electric circuit to make the bulb produce light. Investigates the percentage of students able to complete a circuit with a given apparatus, and the effects of prior experience on student success. Recommends hands-on activities at the elementary and secondary school levels. (Contains 14 references.)…

  4. Power-Switching Circuit

    NASA Technical Reports Server (NTRS)

    Praver, Gerald A.; Theisinger, Peter C.; Genofsky, John

    1987-01-01

    Functions of circuit breakers, meters, and switches combined. Circuit that includes power field-effect transistors (PFET's) provides on/off switching, soft starting, current monitoring, current tripping, and protection against overcurrent for 30-Vdc power supply at normal load currents up to 2 A. Has no moving parts.

  5. Electrically Tuneable EBG Integrated Circuits

    DTIC Science & Technology

    2013-12-01

    fabrication processes leveraging a technique previously developed for Printed Circuit Board (PCB). 15. SUBJECT TERMS Metamaterials, Radio...an integrated circuit (IC) fabrication processes leveraging a technique previously developed for Printed Circuit Board (PCB). Early design work...induces the EBG and as such is not tuneable [1] if implemented as integrated circuits (IC) or printed circuit boards (PCB). Previous work by this

  6. Thermocouple-Signal-Conditioning Circuit

    NASA Technical Reports Server (NTRS)

    Simon, Richard A.

    1991-01-01

    Thermocouple-signal-conditioning circuit acting in conjunction with thermocouple, exhibits electrical behavior of voltage in series with resistance. Combination part of input bridge circuit of controller. Circuit configured for either of two specific applications by selection of alternative resistances and supply voltages. Includes alarm circuit detecting open circuit in thermocouple and provides off-scale output to signal malfunctions.

  7. Intratracheal dopamine attenuates pulmonary edema and improves survival after ventilator-induced lung injury in rats

    PubMed Central

    Chamorro-Marín, Virginia; García-Delgado, Manuel; Touma-Fernández, Angel; Aguilar-Alonso, Eduardo; Fernández-Mondejar, Enrique

    2008-01-01

    Intoduction Clearance of alveolar oedema depends on active transport of sodium across the alveolar-epithelial barrier. β-Adrenergic agonists increase clearance of pulmonary oedema, but it has not been established whether β-agonist stimulation achieves sufficient oedema clearance to improve survival in animals. The objective of this study was to determine whether the increased pulmonary oedema clearance produced by intratracheal dopamine improves the survival of rats after mechanical ventilation with high tidal volume (HVT). Methods This was a randomized, controlled, experimental study. One hundred and thirty-two Wistar-Kyoto rats, weighing 250 to 300 g, were anaesthetized and cannulated via endotracheal tube. Pulmonary oedema was induced by endotracheal instillation of saline solution and mechanical ventilation with HVT. Two types of experiment were carried out. The first was an analysis of pulmonary oedema conducted in six groups of 10 rats ventilated with low (8 ml/kg) or high (25 ml/kg) tidal volume for 30 or 60 minutes with or without intratracheally instilled dopamine. At the end of the experiment the animals were exsanguinated and pulmonary oedema analysis performed. The second experiment was a survival analysis, which was conducted in two groups of 36 animals ventilated with HVT for 60 minutes with or without intratracheal dopamine; survival of the animals was monitored for up to 7 days after extubation. Results In animals ventilated at HVT with or without intratracheal dopamine, oxygen saturation deteriorated over time and was significantly higher at 30 minutes than at 60 minutes. After 60 minutes, a lower wet weight/dry weight ratio was observed in rats ventilated with HVT and instilled with dopamine than in rats ventilated with HVT without dopamine (3.9 ± 0.27 versus 4.9 ± 0.29; P = 0.014). Survival was significantly (P = 0.013) higher in animals receiving intratracheal dopamine and ventilated with HVT, especially at 15 minutes after extubation, when

  8. Cardiovascular effects of mechanical ventilation and weaning.

    PubMed

    Frazier, Susan K

    2008-03-01

    Because of their anatomic position in the closed thoracic cavity, the heart and lungs interact during each ventilation cycle. The application of mechanical ventilation and subsequent removal changes normal ventilatory mechanics and produces alterations in cardiac preload and afterload that influence global hemodynamic state and delivery of oxygen and nutrients. Adverse cardiovascular responses to mechanical ventilation and weaning from ventilation include hemodynamic alterations and instability, myocardial ischemia, autonomic dysfunction, and cardiac dysrhythmias. Clinicians must have a clear understanding of the cardiovascular effects of mechanical ventilation and weaning so they may anticipate, recognize, and effectively manage negative effects and improve patient outcomes.

  9. Economics of mechanical ventilation and respiratory failure.

    PubMed

    Cooke, Colin R

    2012-01-01

    For patients with acute respiratory failure, mechanical ventilation provides the most definitive life-sustaining therapy. Because of the intense resources required to care for these patients, its use accounts for considerable costs. There is great societal need to ensure that use of mechanical ventilation maximizes societal benefits while minimizing costs, and that mechanical ventilation, and ventilator support in general, is delivered in the most efficient and cost-effective manner. This review summarizes the economic aspects of mechanical ventilation and summarizes the existing literature that examines its economic impact cost effectiveness.

  10. Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy.

    PubMed

    Estebanez, A; Pascual, R; Gil, V; Ortiz, F; Santibáñez, M; Pérez Barba, C

    2009-12-01

    The purpose of this paper was to compare the efficacy of a single dose of 3 g of fosfomycin to that of a 7-day regimen of amoxicillin-clavulanate in the treatment of asymptomatic bacteriuria during pregnancy. A randomised, prospective, interventional, analytical, longitudinal study was undertaken, in which the efficacy of two antibiotic regimens (one short and the other long) in the treatment of pregnant women with asymptomatic bacteriuria is compared. One hundred and nine patients were randomly assigned to two groups: 56 were treated with amoxicillin-clavulanate and 53 with fosfomycin. The two groups were similar in terms of co-morbidity, treatments received during pregnancy, obstetric, gynaecological and surgical history and laboratory data. The efficacy of the two regimens was similar and the eradication rate was over 80% in both groups (P = 0.720) (relative risk [RR] 1.195, 95% confidence interval [CI]: 0.451-3.165). The number of reinfections was greater in the amoxicillin-clavulanate group (P = 0.045). The secondary effects were lower in the fosfomycin group (P = 0.008). There were no significant differences in the number of persistences (P = 0.39), development of symptomatic urinary infections (P = 0.319) or recurrences (P = 0.96). Treatment with a single dose of fosfomycin is as effective as the standard course of treatment with amoxicillin-clavulanate and may be preferable due to its simpler administration and the smaller number of reinfections.

  11. The effect of an acute and 7-day administration of magnesium chloride on magnesium concentration in the serum, erythrocytes, and brain of rats.

    PubMed

    Wlaź, Piotr; Serefko, Anna; Szopa, Aleksandra; Poleszak, Ewa

    2016-04-01

    Magnesium (Mg) is one of the most essential cations in human body that is involved in a variety of physiological processes. Despite the variations in the extracellular Mg level, specific transport systems are involved in maintaining the intracellular free Mg at a relatively constant level. We aimed to investigate the changes of Mg level in the brain, erythrocytes, and serum of rats after an acute and subchronic administration of Mg. Magnesium chloride (MgCl2) solution was administered intraperitoneally (ip) either once at a dose of 50mg/kg or for 7 days at a single daily dose of 50mg/kg. Blood and brains of animals were collected 15, 30, 60, 120, and 240min after the acute or the last injection. Total Mg concentration in blood serum, erythrocytes, and the whole brain was determined spectrophotometrically. The highest Mg concentration was detected in the brain tissue, while the most significant changes in Mg level were found in serum. Neither the brain nor the erythrocyte showed a change in the Mg level considerably after an increase in serum Mg level induced by the acute and subchronic administration of MgCl2 solution. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  12. Comparison of abuse, suspected suicidal intent, and fatalities related to the 7-day buprenorphine transdermal patch versus other opioid analgesics in the National Poison Data System.

    PubMed

    Coplan, Paul M; Sessler, Nelson E; Harikrishnan, Venkatesh; Singh, Richa; Perkel, Charles

    2017-01-01

    Prescription opioid related abuse, suicide and death are significant public health problems. This study compares rates of poison center calls categorized as intentional abuse, suspected suicidal intent or fatality for the 7-day buprenorphine transdermal system/patch (BTDS) with other extended-release and long-acting (ER/LA) opioids indicated for chronic pain. Retrospective 24-month cohort study using National Poison Data System data from July 2012 through June 2014. BTDS was introduced in the United States in January 2011. Numbers and rates of calls of intentional abuse, suspected suicidal intent and fatalities were evaluated for BTDS, ER morphine, ER oxycodone, fentanyl patch, ER oxymorphone and methadone tablets/capsules, using prescription adjustment to account for community availability. Rate ratios (RR) and 95% confidence intervals (CI) were calculated. Absolute numbers and prescription-adjusted rates of intentional abuse and suspected suicidal intent with BTDS were significantly lower (p < .0001) than for all other ER/LA opioid analgesics examined. No fatalities associated with BTDS exposure were reported. This post-marketing evaluation of BTDS indicates infrequent poison center calls for intentional abuse and suspected suicidal intent events, suggesting lower rates of these risks with BTDS compared to other ER/LA opioids.

  13. Simultaneous estradiol and levonorgestrel transdermal delivery from a 7-day patch: in vitro and in vivo drug deliveries of three formulations.

    PubMed

    Harrison, Lester I; Zurth, Christian; Gunther, Clemens; Karara, Adel H; Melikian, Armen; Lipp, Ralph

    2007-04-01

    A new drug-in-adhesive transdermal patch was developed to deliver both estradiol and levonorgestrel through the skin over a 7-day period, but at different rates. This report elucidates the in vitro and in vivo biopharmaceutical studies that were necessary during the development of this product. Three test patches had to be manufactured, all delivering estradiol at the same rate, but delivering levonorgestrel at three different rates so that a levonorgestrel dose response could be studied in the clinic. An in vitro hairless mouse skin model (HMS) using modified Franz diffusion cells was used to select the test products delivering levonorgestrel in the order of 1:2:3. HMS experiments also demonstrated that the presence of estradiol did not affect the flux of levonorgestrel. Two in vivo studies in postmenopausal women showed that at steady state (four weeks of once-weekly dosing) the three test products all delivered estradiol at comparable rates. Similarly, the levonorgestrel deliveries for the three test products were in the order expected. The target fluxes of both drugs were achieved in these three test products by varying the drug loads and patch size. That this approach was successful is evidence of the value of using the HMS penetration experiments in transdermal product development and should provide useful insights for other formulations having to develop complex systems. One of the test products is now marketed as Climara Pro.

  14. Compensated gain control circuit for buck regulator command charge circuit

    DOEpatents

    Barrett, David M.

    1996-01-01

    A buck regulator command charge circuit includes a compensated-gain control signal for compensating for changes in the component values in order to achieve optimal voltage regulation. The compensated-gain control circuit includes an automatic-gain control circuit for generating a variable-gain control signal. The automatic-gain control circuit is formed of a precision rectifier circuit, a filter network, an error amplifier, and an integrator circuit.

  15. Compensated gain control circuit for buck regulator command charge circuit

    DOEpatents

    Barrett, D.M.

    1996-11-05

    A buck regulator command charge circuit includes a compensated-gain control signal for compensating for changes in the component values in order to achieve optimal voltage regulation. The compensated-gain control circuit includes an automatic-gain control circuit for generating a variable-gain control signal. The automatic-gain control circuit is formed of a precision rectifier circuit, a filter network, an error amplifier, and an integrator circuit. 5 figs.

  16. Patient-ventilator interaction: an overview.

    PubMed

    Prinianakis, George; Kondili, Eumorfia; Georgopoulos, Dimitris

    2005-06-01

    During assisted mechanical ventilation, the total pressure applied to respiratory system is the sum of ventilator and muscle pressure. As a result, the respiratory system is under the influence of two pumps, the ventilator pump (ie, Paw), which is controlled by the physician's brain and the capabilities of the ventilator, and the patient's own respiratory muscle pump (Pmus), which is controlled by the patient's brain. The patient-ventilator interaction is mainly an expression of the function of these two brains, which should be in harmony to promote patient-ventilator synchrony. The achievement of this harmony depends exclusively on the physician, who should be aware that during assisted mechanical ventilation the respiratory system is not a passive structure but reacts to pressure delivered by the ventilator via various feedback systems and, depending on several factors both to the ventilator and patient, may modify the function of the ventilator. Finally, the physician should know that the ventilator imposes significant constraints to the respiratory system, the magnitude of which depends heavily on the triggering variable, the variable that controls the gas delivery and the cycling off criterion.

  17. Night ventilation control strategies in office buildings

    SciTech Connect

    Wang, Zhaojun; Yi, Lingli; Gao, Fusheng

    2009-10-15

    In moderate climates night ventilation is an effective and energy-efficient approach to improve the indoor thermal environment for office buildings during the summer months, especially for heavyweight construction. However, is night ventilation a suitable strategy for office buildings with lightweight construction located in cold climates? In order to answer this question, the whole energy-consumption analysis software EnergyPlus was used to simulate the indoor thermal environment and energy consumption in typical office buildings with night mechanical ventilation in three cities in northern China. The summer outdoor climate data was analyzed, and three typical design days were chosen. The most important factors influencing night ventilation performance such as ventilation rates, ventilation duration, building mass and climatic conditions were evaluated. When night ventilation operation time is closer to active cooling time, the efficiency of night ventilation is higher. With night ventilation rate of 10 ach, the mean radiant temperature of the indoor surface decreased by up to 3.9 C. The longer the duration of operation, the more efficient the night ventilation strategy becomes. The control strategies for three locations are given in the paper. Based on the optimized strategies, the operation consumption and fees are calculated. The results show that more energy is saved in office buildings cooled by a night ventilation system in northern China than ones that do not employ this strategy. (author)

  18. Airway pressure release ventilation: theory and practice.

    PubMed

    Frawley, P M; Habashi, N M

    2001-05-01

    Airway pressure release ventilation (APRV) is a relatively new mode of ventilation, that only became commercially available in the United States in the mid-1990s. Airway pressure release ventilation produces tidal ventilation using a method that differs from any other mode. It uses a release of airway pressure from an elevated baseline to simulate expiration. The elevated baseline facilitates oxygenation, and the timed releases aid in carbon dioxide removal. Advantages of APRV include lower airway pressures, lower minute ventilation, minimal adverse effects on cardio-circulatory function, ability to spontaneously breathe throughout the entire ventilatory cycle, decreased sedation use, and near elimination of neuromuscular blockade. Airway pressure release ventilation is consistent with lung protection strategies that strive to limit lung injury associated with mechanical ventilation. Future research will probably support the use of APRV as the primary mode of choice for patients with acute lung injury.

  19. Improving aerosol drug delivery during invasive mechanical ventilation with redesigned components.

    PubMed

    Longest, P Worth; Azimi, Mandana; Golshahi, Laleh; Hindle, Michael

    2014-05-01

    Patients receiving invasive mechanical ventilation with an endotracheal tube (ETT) can often benefit from pharmaceutical aerosols; however, drug delivery through the ventilator circuit is known to be very inefficient. The objective of this study was to improve the delivery of aerosol through an invasive mechanical ventilation system by redesigning circuit components using a streamlining approach. Redesigned components were the T-connector interface between the nebulizer and ventilator line and the Y-connector leading to the ETT. The streamlining approach seeks to minimize aerosol deposition and loss by eliminating sharp changes in flow direction and tubing diameter that lead to flow disruption. Both in vitro experiments and computational fluid dynamic (CFD) simulations were applied to analyze deposition and emitted dose of drug for multiple droplet size distributions, flows, and ETT sizes used in adults. The experimental results demonstrated that the streamlined components improved delivery through the circuit by factors ranging from 1.3 to 1.5 compared with a commercial system for adult ETT sizes of 8 and 9 mm. The overall delivery efficiency was based on the bimodal aspect of the aerosol distributions and could not be predicted by median diameter alone. CFD results indicated a 20-fold decrease in turbulence in the junction region for the streamlined Y resulting in a maximum 9-fold decrease in droplet deposition. The relative effectiveness of the streamlined designs was found to increase with increasing particle size and increasing flow, with a maximum improvement in emitted dose of 1.9-fold. Streamlined components can significantly improve the delivery of pharmaceutical aerosols during mechanical ventilation based on an analysis of multiple aerosol generation devices, ETT sizes, and flows.

  20. Approximate circuits for increased reliability

    DOEpatents

    Hamlet, Jason R.; Mayo, Jackson R.

    2015-12-22

    Embodiments of the invention describe a Boolean circuit having a voter circuit and a plurality of approximate circuits each based, at least in part, on a reference circuit. The approximate circuits are each to generate one or more output signals based on values of received input signals. The voter circuit is to receive the one or more output signals generated by each of the approximate circuits, and is to output one or more signals corresponding to a majority value of the received signals. At least some of the approximate circuits are to generate an output value different than the reference circuit for one or more input signal values; however, for each possible input signal value, the majority values of the one or more output signals generated by the approximate circuits and received by the voter circuit correspond to output signal result values of the reference circuit.

  1. Approximate circuits for increased reliability

    SciTech Connect

    Hamlet, Jason R.; Mayo, Jackson R.

    2015-08-18

    Embodiments of the invention describe a Boolean circuit having a voter circuit and a plurality of approximate circuits each based, at least in part, on a reference circuit. The approximate circuits are each to generate one or more output signals based on values of received input signals. The voter circuit is to receive the one or more output signals generated by each of the approximate circuits, and is to output one or more signals corresponding to a majority value of the received signals. At least some of the approximate circuits are to generate an output value different than the reference circuit for one or more input signal values; however, for each possible input signal value, the majority values of the one or more output signals generated by the approximate circuits and received by the voter circuit correspond to output signal result values of the reference circuit.

  2. Summary of human responses to ventilation

    SciTech Connect

    Seppanen, Olli A.; Fisk, William J.

    2004-06-01

    The effects of ventilation on indoor air quality and health is a complex issue. It is known that ventilation is necessary to remove indoor generated pollutants from indoor air or dilute their concentration to acceptable levels. But, as the limit values of all pollutants are not known, the exact determination of required ventilation rates based on pollutant concentrations and associated risks is seldom possible. The selection of ventilation rates has to be based also on epidemiological research (e.g. Seppanen et al., 1999), laboratory and field experiments (e.g. CEN 1996, Wargocki et al., 2002a) and experience (e.g. ECA 2003). Ventilation may also have harmful effects on indoor air quality and climate if not properly designed, installed, maintained and operated as summarized by Seppdnen (2003). Ventilation may bring indoors harmful substances that deteriorate the indoor environment. Ventilation also affects air and moisture flow through the building envelope and may lead to moisture problems that deteriorate the structures of the building. Ventilation changes the pressure differences over the structures of building and may cause or prevent the infiltration of pollutants from structures or adjacent spaces. Ventilation is also in many cases used to control the thermal environment or humidity in buildings. Ventilation can be implemented with various methods which may also affect health (e.g. Seppdnen and Fisk, 2002, Wargocki et al., 2002a). In non residential buildings and hot climates, ventilation is often integrated with air-conditioning which makes the operation of ventilation system more complex. As ventilation is used for many purposes its health effects are also various and complex. This paper summarizes the current knowledge on positive and negative effects of ventilation on health and other human responses. The focus of the paper is on office-type working environment and residential buildings. In the industrial premises the problems of air quality are usually

  3. Polymorphic Electronic Circuits

    NASA Technical Reports Server (NTRS)

    Stoica, Adrian

    2004-01-01

    Polymorphic electronics is a nascent technological discipline that involves, among other things, designing the same circuit to perform different analog and/or digital functions under different conditions. For example, a circuit can be designed to function as an OR gate or an AND gate, depending on the temperature (see figure). Polymorphic electronics can also be considered a subset of polytronics, which is a broader technological discipline in which optical and possibly other information- processing systems could also be designed to perform multiple functions. Polytronics is an outgrowth of evolvable hardware (EHW). The basic concepts and some specific implementations of EHW were described in a number of previous NASA Tech Briefs articles. To recapitulate: The essence of EHW is to design, construct, and test a sequence of populations of circuits that function as incrementally better solutions of a given design problem through the selective, repetitive connection and/or disconnection of capacitors, transistors, amplifiers, inverters, and/or other circuit building blocks. The evolution is guided by a search-and-optimization algorithm (in particular, a genetic algorithm) that operates in the space of possible circuits to find a circuit that exhibits an acceptably close approximation of the desired functionality. The evolved circuits can be tested by computational simulation (in which case the evolution is said to be extrinsic), tested in real hardware (in which case the evolution is said to be intrinsic), or tested in random sequences of computational simulation and real hardware (in which case the evolution is said to be mixtrinsic).

  4. Sensor readout detector circuit

    DOEpatents

    Chu, Dahlon D.; Thelen, Jr., Donald C.

    1998-01-01

    A sensor readout detector circuit is disclosed that is capable of detecting sensor signals down to a few nanoamperes or less in a high (microampere) background noise level. The circuit operates at a very low standby power level and is triggerable by a sensor event signal that is above a predetermined threshold level. A plurality of sensor readout detector circuits can be formed on a substrate as an integrated circuit (IC). These circuits can operate to process data from an array of sensors in parallel, with only data from active sensors being processed for digitization and analysis. This allows the IC to operate at a low power level with a high data throughput for the active sensors. The circuit may be used with many different types of sensors, including photodetectors, capacitance sensors, chemically-sensitive sensors or combinations thereof to provide a capability for recording transient events or for recording data for a predetermined period of time following an event trigger. The sensor readout detector circuit has applications for portable or satellite-based sensor systems.

  5. Sensor readout detector circuit

    DOEpatents

    Chu, D.D.; Thelen, D.C. Jr.

    1998-08-11

    A sensor readout detector circuit is disclosed that is capable of detecting sensor signals down to a few nanoamperes or less in a high (microampere) background noise level. The circuit operates at a very low standby power level and is triggerable by a sensor event signal that is above a predetermined threshold level. A plurality of sensor readout detector circuits can be formed on a substrate as an integrated circuit (IC). These circuits can operate to process data from an array of sensors in parallel, with only data from active sensors being processed for digitization and analysis. This allows the IC to operate at a low power level with a high data throughput for the active sensors. The circuit may be used with many different types of sensors, including photodetectors, capacitance sensors, chemically-sensitive sensors or combinations thereof to provide a capability for recording transient events or for recording data for a predetermined period of time following an event trigger. The sensor readout detector circuit has applications for portable or satellite-based sensor systems. 6 figs.

  6. Pulsed Dose Delivery of Oxygen in Mechanically Ventilated Pigs with Acute Lung Injury

    DTIC Science & Technology

    2013-03-01

    atropine (0.54 mg/kg). They were then intubated with 7.5 French endotracheal tubes. A surgical plane of anesthesia was maintained with isoflurane...patients often require intubation and mechanical ventilation with supplemental oxygen and positive end-expiratory pressure (PEEP). To date, the...circuit, directly at the endotracheal tube. We used the SeQual Eclipse II, which was selected for its oxygen generating capabilities, as it is capable

  7. DIFFERENTIAL FAULT SENSING CIRCUIT

    DOEpatents

    Roberts, J.H.

    1961-09-01

    A differential fault sensing circuit is designed for detecting arcing in high-voltage vacuum tubes arranged in parallel. A circuit is provided which senses differences in voltages appearing between corresponding elements likely to fault. Sensitivity of the circuit is adjusted to some level above which arcing will cause detectable differences in voltage. For particular corresponding elements, a group of pulse transformers are connected in parallel with diodes connected across the secondaries thereof so that only voltage excursions are transmitted to a thyratron which is biased to the sensitivity level mentioned.

  8. Gallium Arsenide Domino Circuit

    NASA Technical Reports Server (NTRS)

    Yang, Long; Long, Stephen I.

    1990-01-01

    Advantages include reduced power and high speed. Experimental gallium arsenide field-effect-transistor (FET) domino circuit replicated in large numbers for use in dynamic-logic systems. Name of circuit denotes mode of operation, which logic signals propagate from each stage to next when successive stages operated at slightly staggered clock cycles, in manner reminiscent of dominoes falling in a row. Building block of domino circuit includes input, inverter, and level-shifting substages. Combinational logic executed in input substage. During low half of clock cycle, result of logic operation transmitted to following stage.

  9. Monolithic microwave integrated circuits

    NASA Astrophysics Data System (ADS)

    Pucel, R. A.

    Monolithic microwave integrated circuits (MMICs), a new microwave technology which is expected to exert a profound influence on microwave circuit designs for future military systems as well as for the commercial and consumer markets, is discussed. The book contains an historical discussion followed by a comprehensive review presenting the current status in the field. The general topics of the volume are: design considerations, materials and processing considerations, monolithic circuit applications, and CAD, measurement, and packaging techniques. All phases of MMIC technology are covered, from design to testing.

  10. Stockpiling Ventilators for Influenza Pandemics

    PubMed Central

    Araz, Ozgur M.; Morton, David P.; Johnson, Gregory P.; Damien, Paul; Clements, Bruce; Meyers, Lauren Ancel

    2017-01-01

    In preparing for influenza pandemics, public health agencies stockpile critical medical resources. Determining appropriate quantities and locations for such resources can be challenging, given the considerable uncertainty in the timing and severity of future pandemics. We introduce a method for optimizing stockpiles of mechanical ventilators, which are critical for treating hospitalized influenza patients in respiratory failure. As a case study, we consider the US state of Texas during mild, moderate, and severe pandemics. Optimal allocations prioritize local over central storage, even though the latter can be deployed adaptively, on the basis of real-time needs. This prioritization stems from high geographic correlations and the slightly lower treatment success assumed for centrally stockpiled ventilators. We developed our model and analysis in collaboration with academic researchers and a state public health agency and incorporated it into a Web-based decision-support tool for pandemic preparedness and response. PMID:28518041

  11. Measurement of free GH and bioactive IGF-I in non-diabetic haemodialysis patients treated with GH for 7 days.

    PubMed

    Frystyk, Jan; Djurhuus, Christian Born; Johansen, Thue; Lange, Martin; Smidt, Kamille; Christiansen, Jens Sandahl

    2012-11-01

    End-stage renal failure (ESRF) patients demonstrate augmented growth hormone (GH) secretion, but normal insulin-like growth factor-I (IGF-I) concentrations, indicating a state of GH resistance. To test this hypothesis, we compared the IGF-I response with exogenous GH in haemodialysis patients and healthy controls, with special focus on free GH and bioactive IGF-I. Ultrafiltered free GH and total GH were measured in serum collected hourly for 24 h at baseline and after 7 days of recombinant human (rh) GH (50 µg/kg/day) treatment in 11 non-diabetic haemodialysis patients and 10 matched controls. Serum levels of bioactive IGF-I (determined by cell-based IGF-I receptor activation assay), total IGF-I and the GH-binding protein (GHBP) were assayed twice daily. At baseline, patients showed elevated total GH (24 ± 5 versus 9 ± 1 µg/L × h, P < 0.02), free GH (21 ± 5 versus 7 ± 1 µg/L × h, P < 0.02), reduced GHBP (1.5 ± 0.3 versus 2.5 ± 0.2 nmol/L, P < 0.01), high-normal total IGF-I (173 ± 18 versus 135 ± 14 µg/L, P = 0.12) and subnormal bioactive IGF-I (2.1 ± 0.3 versus 2.8 ± 0.2 µg/L, P < 0.05) when compared with controls. After 7 days of rhGH treatment, there was a greater GH increase in the non-diabetic haemodialysis patients than in controls (total GH: 293 ± 33 versus 166 ± 13 µg/L × h, P < 0.001; free GH: 284 ± 40 versus 126 ± 15 µg/L × h, P < 0.001). GHB remained unaffected and total IGF-I increased to the same extent in patients and controls (701 ± 87 versus 572 ± 33 µg/L, P = 0.17), whereas bioactive IGF-I tended to be lower in patients (5.37 ± 0.55 versus 6.63 ± 0.25 µg/L, P < 0.10). When adjusting for the actual increments in plasma GH, the ability of exogenous GH to stimulate bioactive IGF-I levels was reduced by ~50% in ESRF (P < 0.02), whereas the response of total IGF-I remained normal (74%; P= 0.18) The study demonstrates that ESRF is associated with markedly elevated serum levels of free GH. Furthermore changes in bioactive

  12. Comparison of follicular dynamics and hormone concentrations between the 7-day and 5-day CO-Synch + CIDR program in primiparous beef cows.

    PubMed

    Bridges, G A; Mussard, M L; Helser, L A; Day, M L

    2014-03-01

    The objectives were to compare follicular dynamics, preovulatory estradiol concentrations, and progesterone concentrations between the 7-day (7CO, n = 15) and 5-day (5CO, n = 13) CO-Synch + controlled internal drug release device (CIDR) program in primiparous suckled beef cows. On Day -7 (7CO) or Day -5 (5CO), GnRH (100 μg) was administered (GnRH-1) and a CIDR was inserted. On Day 0, hour 0, CIDR was removed and cows received PGF2α (25 mg) at hours 0 and 12. Animals were administered GnRH (100 μg, GnRH-2) at either hour 60 (7CO) or 72 (5CO). Follicular growth and ovulation to both GnRH-1 and GnRH-2 were evaluated using ultrasonography. Concentrations of estradiol were determined in blood samples taken at hours 0, 36, 60, and 72 (5CO). Blood samples were collected on Days 5, 8, and 14 for progesterone quantification. Ovulation rate to GnRH-1 did not differ between the 7CO (11/15) and 5CO (8/13) treatments, and for all dependent variables the statistical model included treatment, ovulation to GnRH-1, and their interaction. Diameter (mm) of the ovulatory follicle did not differ between treatments (13.4 ± 0.3) but was greater (P < 0.05) in cows that responded to GnRH-1 (13.8 ± 0.3) than those did not (12.6 ± 0.6). Maximum estradiol concentrations tended (P = 0.06) to be greater in the 5CO (7.3 ± 0.5 pg/mL) than 7CO (6.1 ± 0.7 pg/mL) treatment and tended to be greater (P = 0.08) in cows that responded to GnRH-1 (7.1 ± 0.5 pg/mL) than those did not (5.6 ± 0.9 pg/mL). Three cows in the 7CO treatment failed to develop a CL after GnRH-2. There was a treatment by response to GnRH-1 interaction (P < 0.05) for progesterone concentrations. In cows that did not respond to GnRH-1 in the 7CO treatment, progesterone concentrations were less (P < 0.05) than in those that responded to GnRH-1 in the 7CO treatment and tended (P = 0.09) to be less than in cows in the 5CO treatment that did not respond to GnRH-1. In conclusion, these findings demonstrate that failure to

  13. Calculation of the fresh gas flow requirements of the Hafnia A and D anaesthetic circuits.

    PubMed

    Thomsen, A

    1980-01-01

    Semi-closed anaesthetic circuits are converted into the corresponding Hafnia circuits by replacing the expiratory valve by a side tube connected to an ejector flowmeter. Theoretical analysis of the Hafnia A and D circuits revealed by the fresh gas flow requirements are dependent on the inspiration/expiration time ratio. Using a ratio of 1/1.2 and a sine-wave respiratory waveform, the minimal fresh gas requirements were calculated as 2.1 (Hafnia A) and 2.5 (Hafnia D) times the respiratory minute volume. The fresh gas requirements are identical with spontaneous or controlled ventilation.

  14. The Sedentary Time and Activity Reporting Questionnaire (STAR-Q): reliability and validity against doubly labeled water and 7-day activity diaries.

    PubMed

    Csizmadi, Ilona; Neilson, Heather K; Kopciuk, Karen A; Khandwala, Farah; Liu, Andrew; Friedenreich, Christine M; Yasui, Yutaka; Rabasa-Lhoret, Rémi; Bryant, Heather E; Lau, David C W; Robson, Paula J

    2014-08-15

    We determined measurement properties of the Sedentary Time and Activity Reporting Questionnaire (STAR-Q), which was designed to estimate past-month activity energy expenditure (AEE). STAR-Q validity and reliability were assessed in 102 adults in Alberta, Canada (2009-2011), who completed 14-day doubly labeled water (DLW) protocols, 7-day activity diaries on day 15, and the STAR-Q on day 14 and again at 3 and 6 months. Three-month reliability was substantial for total energy expenditure (TEE) and AEE (intraclass correlation coefficients of 0.84 and 0.73, respectively), while 6-month reliability was moderate. STAR-Q-derived TEE and AEE were moderately correlated with DLW estimates (Spearman's ρs of 0.53 and 0.40, respectively; P < 0.001), and on average, the STAR-Q overestimated TEE and AEE (median differences were 367 kcal/day and 293 kcal/day, respectively). Body mass index-, age-, sex-, and season-adjusted concordance correlation coefficients (CCCs) were 0.24 (95% confidence interval (CI): 0.07, 0.36) and 0.21 (95% CI: 0.11, 0.32) for STAR-Q-derived versus DLW-derived TEE and AEE, respectively. Agreement between the diaries and STAR-Q (metabolic equivalent-hours/day) was strongest for occupational sedentary time (adjusted CCC = 0.76, 95% CI: 0.64, 0.85) and overall strenuous activity (adjusted CCC = 0.64, 95% CI: 0.49, 0.76). The STAR-Q demonstrated substantial validity for estimating occupational sedentary time and strenuous activity and fair validity for ranking individuals by AEE. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Calibration of a subcutaneous amperometric glucose sensor implanted for 7 days in diabetic patients. Part 2. Superiority of the one-point calibration method.

    PubMed

    Choleau, C; Klein, J C; Reach, G; Aussedat, B; Demaria-Pesce, V; Wilson, G S; Gifford, R; Ward, W K

    2002-08-01

    Calibration, i.e. the transformation in real time of the signal I(t) generated by the glucose sensor at time t into an estimation of glucose concentration G(t), represents a key issue for the development of a continuous glucose monitoring system. To compare two calibration procedures. In the one-point calibration, which assumes that I(o) is negligible, S is simply determined as the ratio I/G, and G(t) = I(t)/S. The two-point calibration consists in the determination of a sensor sensitivity S and of a background current I(o) by plotting two values of the sensor signal versus the concomitant blood glucose concentrations. The subsequent estimation of G(t) is given by G(t) = (I(t)-I(o))/S. A glucose sensor was implanted in the abdominal subcutaneous tissue of nine type 1 diabetic patients during 3 (n = 2) and 7 days (n = 7). The one-point calibration was performed a posteriori either once per day before breakfast, or twice per day before breakfast and dinner, or three times per day before each meal. The two-point calibration was performed each morning during breakfast. The percentages of points present in zones A and B of the Clarke Error Grid were significantly higher when the system was calibrated using the one-point calibration. Use of two one-point calibrations per day before meals was virtually as accurate as three one-point calibrations. This study demonstrates the feasibility of a simple method for calibrating a continuous glucose monitoring system.

  16. Trichilia monadelpha bark extracts inhibit carrageenan-induced foot-oedema in the 7-day old chick and the oedema associated with adjuvant-induced arthritis in rats.

    PubMed

    Ainooson, G K; Owusu, G; Woode, E; Ansah, C; Annan, K

    2012-01-01

    Trichilia monadelpha (Thonn) JJ De Wilde (Meliaceae) bark extract is used in African traditional medicine for the management of various disease conditions including inflammatory disorders such as arthritis. The present study was undertaken to evaluate the anti-inflammatory properties of aqueous (TWE), alcoholic (TAE) and petroleum ether extract (TPEE) of T. monadelpha using the 7-day old chick-carrageenan footpad oedema (acute inflammation) and the adjuvant-induced arthritis model in rats (chronic inflammation). TWE and TPEE significantly inhibited the chick-carrageenan footpad oedema with maximal inhibitions of 57.79±3.92 and 63.83±12 respectively, but TAE did not. The reference anti-inflammatory drugs (diclofenac and dexamethasone) inhibited the chick-carrageenan-induced footpad oedema, with maximal inhibitions of 64.92±2.03 and 71.85±15.34 respectively. Furthermore, all the extracts and the reference anti-inflammatory agents (diclofenac, dexamethasone, methotrexate) inhibited the inflammatory oedema associated with adjuvant arthritis with maximal inhibitions of 64.41±5.56, 57.04±8.57, 62.18±2.56%, for TWE, TAE and TPEE respectively and 80.28±5.79, 85.75±2.96, 74.68±3.03% for diclofenac, dexamethasone and methotrexate respectively. Phytochemical screening of the plant bark confirmed the presence of a large array of plant constituents such as alkaloids, glycosides, flavonoids, saponins, steroids, tannins and terpenoids, all of which may be potential sources of phyto-antiinflammatory agents. In conclusion, our work suggests that T. monadelpha is a potential source of antiinflammatory agents.

  17. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study.

    PubMed

    Allard, Johane P; Keller, Heather; Jeejeebhoy, Khursheed N; Laporte, Manon; Duerksen, Don R; Gramlich, Leah; Payette, Helene; Bernier, Paule; Davidson, Bridget; Teterina, Anastasia; Lou, Wendy

    2016-02-01

    Reducing length of stay (LOS) is a priority for hospitals but patients' decline in nutritional status may have a negative impact. The aims of the study were to assess the change in nutritional status during hospitalization and determine if its decline is associated with prolonged LOS. This is a prospective cohort study conducted in 18 Canadian hospitals. Subjective global assessment (SGA) and weight measurements were performed at admission and discharge. Patient information was collected at admission and extracted from the chart during hospitalization. Association between LOS and changes in SGA or weight loss ≥5% was tested using multivariate Cox PH approach. Results are expressed as hazard ratios (HR) and their 95% CI. 409 patients (53% male) with a LOS >7 days were analyzed. Patients' median (q1,q3) age was 68 years (58,79) and LOS was 11 days (8,17). At admission, 49% of patients were well nourished (SGA A), 37% were moderately malnourished (SGA B) and 14% were severely malnourished (SGA C). From admission to discharge, 34% remained well-nourished, 29% remained malnourished (SGA B or C), 20% deteriorated and 17% improved. Of the 409 patients, 373 had weight measurements at admission and discharge: 92 (25%) had ≥5% weight loss. Multivariate models showed that after adjusting for covariates, decline in nutritional status from SGA A to B/C or SGA B to C (HR: 0.62, CI: (0.44, 0.87); HR: 0.35, CI: (0.20, 0.62) respectively) and weight loss ≥5% (HR: 0.52; CI: 0.40, 0.69) were significantly associated with longer LOS. In-hospital decline in nutritional status as assessed by SGA or weight loss ≥5% is associated with prolonged LOS independently of factors reflecting demographics, living accommodations and disease severity. This suggests a role for nutrition care in reducing LOS. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Concentrations of dapivirine in the rhesus macaque and rabbit following once daily intravaginal administration of a gel formulation of [14C]dapivirine for 7 days.

    PubMed

    Nuttall, Jeremy P; Thake, Daryl C; Lewis, Mark G; Ferkany, John W; Romano, Joseph W; Mitchnick, Mark A

    2008-03-01

    Dapivirine is a nonnucleoside reverse transcriptase inhibitor being developed as a topical microbicide for the prevention of human immunodeficiency virus infection. The distribution of radioactivity and drug in plasma and in vaginal, cervical, and draining lymph node tissues was investigated after daily application of a vaginal gel formulation of [14C]dapivirine to rhesus macaques. This was preceded by a preliminary study with rabbits. Following the intravaginal administration of [14C]dapivirine ( approximately 0.1 mg/ml [15 microCi/ml]) to rabbits (0.5 ml/day) and macaques (1 ml/day) for 7 days, the dapivirine levels associated with vaginal and cervical tissue samples 1 h after the final dose were high (quantities of microg/g of tissue) and remained detectable at 24 h (mean, >or=2.5 ng/g in rabbits) and 48 h (mean, >80 ng/g in macaques). Radioactivity levels were low in the plasma and very low or unquantifiable in the draining lymph nodes of the macaques. Microautoradiography identified drug-related material (DRM) on the surfaces of the vaginal and cervical tissues of the rabbits and macaques. Although DRM was primarily associated with the outermost layer of shedding cells in rabbits, two animals showed some evidence of small quantities in the mucosal epithelium of the cervix. In macaques, DRM was seen within the keratinized layer of the vaginal epithelium and and was found to extend into the superficial cellular layers, and in at least one animal it appeared to be present in the deepest (germinal) layer of the epithelium and in submucosal tissues. The persistence of biologically significant concentrations of dapivirine in vaginal and cervical tissues for >24 h supports the development of dapivirine as a microbicide for once daily application.

  19. Efficacy and safety of short course (5-day) moxifloxacin vs 7-day ceftriaxone in the treatment of acute exacerbations of chronic bronchitis (AECB).

    PubMed

    Grassi, C; Casali, L; Curti, E; Tellarini, M; Lazzaro, C; Schito, G

    2002-12-01

    The aim of this multicenter, open, randomized study was to compare the efficacy and tolerability of a 5-day treatment course with oral moxifloxacin (MXF) vs a 7-day course with i.m. ceftriaxone (CRO) in 476 patients with acute exacerbations of chronic bronchitis (AECB), and to conduct a cost minimization analysis of the two treatments from the perspectives of both the Italian National Health Service (INHS) and society. The study was conducted in Italy. Clinical success rates at test-of-cure in the 423 patients of the PP (Per Protocol) population (primary efficacy parameter) were 90.6% and 89.0% for MXF and CRO, respectively. Statistical non-inferiority of MXF vs CRO was confirmed. Similar results were found between study drugs on the secondary efficacy parameters, including success at end-of-treatment (95.3% for MXF vs 92.9% for CRO), success at test-of-cure in bacteriologically-positive patients (94.1% vs 90.7%) and eradication/presumed eradication rates (91.7% vs 93.3%). ITT (Intention-to-Treat) analysis confirmed these data. There was a low incidence of adverse events (10.8% vs 9.1%). During a 6-month follow-up period, relapse rates were lower for MXF vs CRO (23.3% vs 28.3%; p > .05). Compared with CRO, MXF was associated with cost savings per patient ranging from Euro226.57 (INHS perspective) to Euro448.23 (societal perspective), with lower hospitalization rate the major variable contributing to reduced costs. MXF appears to be an ideal candidate for AECB treatment.

  20. Effect of chlorine treatment on inhibition of E. coli serogroup O2 incorporation into 7-day-old biofilm on polyvinylchloride surface.

    PubMed

    Maharjan, P; Dey, S; Huff, G; Zhang, W; Phillips, G K; Watkins, S

    2017-04-17

    Poultry waterlines are constructed using polyvinylchloride (PVC) material on which bacterial biofilm can easily form. Biofilm can harbor pathogens including avian pathogenic E. coli (APEC) strains. An in vitro evaluation was performed to determine if E. coli sero group O2 (avian pathogenic) could attach on a PVC surface that had pre-formed biofilm and if this phenomenon could be affected when water was treated with chlorine. Initially, biofilm growth was induced in PVC test coupons (15.16 cm2) for a 7-day period mimicking the waterline scenario in the first wk of poultry brooding; and then this biofilm was challenged with E. coli O2 seeded water in presence/absence of chlorine treatment. After rinsing, test coupons were sampled for bacterial (APC) and E. coli O2 enumeration at various occasions post seeding the pathogen and chlorine treatment. Day 7 APC recovered from coupons was 4.35 log10 cfu/cm2 in trial 1 and 3.66 log10 cfu/cm2 in trial 2. E. coli O2 was not recovered from chlorine treated test coupons (P < 0.05), whereas it was retrieved from untreated coupons (untreated contained > 3 log10 cfu/cm2 in trial 1 and > 2 log10 cfu/cm2 in trial 2). This study suggests that E. coli O2 can incorporate into pre-formed biofilm on a PVC surface within 24 h if water sanitation is not present, and the attachment time of the pathogen can prolong in the absence of already formed biofilm. © 2017 Poultry Science Association Inc.

  1. Energy balance in haemodialysis and peritoneal dialysis patients assessed by a 7-day weighed food diary and a portable armband device.

    PubMed

    Bovio, G; Montagna, G; Brazzo, S; Piazza, V; Segagni, S; Cena, H

    2013-06-01

    Energy balance (EB) is important when assessing nutritional status. EB has never been assessed in haemodialysis (HD) and peritoneal dialysis (PD) patients. The present study aimed to assess weekly EB in these patients. This clinical cross-sectional study was conducted for 7 days in eight HD and eight PD patients. Nutritional status was assessed by anthropometry, bioelectrical impedance analysis and biochemical markers. Energy intake (EI per day) and total energy expenditure (TEE per day) were determined by a 7-day weighed food diary and a portable armband device, respectively. No significant differences in age, body mass index, fat free mass (FFM), parathyroid hormone were found between the two groups. EB was calculated by subtracting TEE per day from EI per day. EB was negative in HD {-1347 (1276) kJ day(-1) [-322 (305) kcal day(-1) ]}, as well as in PD patients {-427 (5338) kJ day(-1) [-102 (395) kcal day(-1) ]}. TEE per day was positively correlated with EI per day, prealbumin, FFM. EI per day was positively correlated with prealbumin. C-reactive protein was negatively correlated with TEE and FFM (P < 0.05). EB showed a positive correlation with EI per day (P = 0.012) and a negative trend with TEE. HD and PD patients have a negative EB and are at risk of malnutrition. Inflammatory status determines a lower EI per day and a reduction in TEE per day. The most important parameter in determining EB in HD and PD patients is EI per day. This topic deserves further investigation to better understand the mechanisms of impaired EB with respect to preserving patients' nutritional status. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  2. Dose-Response Assessment of Nephrotoxicity from a 7-Day Combined Exposure to Melamine and Cyanuric Acid in F344 Rats

    PubMed Central

    Jacob, Cristina C.; Reimschuessel, Renate; Von Tungeln, Linda S.; Olson, Greg R.; Warbritton, Alan R.; Hattan, David G.; Beland, Frederick A.; Gamboa da Costa, Gonçalo

    2011-01-01

    The intentional adulteration of pet food with melamine and derivatives, including cyanuric acid, has been implicated in the kidney failure and death of a large number of cats and dogs in the United States. Although individually these compounds present low toxicity, coexposure can lead to the formation of melamine cyanurate crystals in the nephrons and eventual kidney failure. To determine the dose-response for nephrotoxicity upon coadministration of melamine and cyanuric acid, groups of male and female F344 rats (six animals per sex per group) were fed 0 (control), 7, 23, 69, 229, or 694 ppm of both melamine and cyanuric acid; 1388 ppm melamine; or 1388 ppm cyanuric acid in the diet for 7 days. No toxicity was observed in the rats exposed to the individual compounds, whereas anorexia and a statistically significant increase in blood urea nitrogen and serum creatinine levels was observed in the animals treated with 229 and 694 ppm melamine and cyanuric acid. The kidneys of these animals were grossly enlarged and pale yellow. Large numbers of crystalline structures deposited in the tubules were seen on sections in kidneys from all rats in these treatment groups. No significant changes were detected in the remaining treatment groups exposed to both melamine and cyanuric acid. In the melamine-only treatment group, 5 of 12 rats had scattered crystals present in renal tubules when examined by wet mount. These were not observed by histopathology. The observed adverse effect level (8.6 mg/kg bw [body weight]/day) and benchmark dose modeling data (8.4–10.9 mg/kg bw/day) determined in this study suggest that the tolerable daily intake values derived from studies conducted with melamine alone may underestimate the risk from coexposures to melamine and cyanuric acid. PMID:21030430

  3. A phase I trial of the selective oral cyclin-dependent kinase inhibitor seliciclib (CYC202; R-Roscovitine), administered twice daily for 7 days every 21 days

    PubMed Central

    Benson, C; White, J; Bono, J De; O'Donnell, A; Raynaud, F; Cruickshank, C; McGrath, H; Walton, M; Workman, P; Kaye, S; Cassidy, J; Gianella-Borradori, A; Judson, I; Twelves, C

    2006-01-01

    Seliciclib (CYC202; R-roscovitine) is the first selective, orally bioavailable inhibitor of cyclin-dependent kinases 1, 2, 7 and 9 to enter clinical trial. Preclinical studies showed antitumour activity in a broad range of human tumour xenografts. A phase I trial was performed with a 7-day b.i.d. p.o. schedule. Twenty-one patients (median age 62 years, range: 39–73 years) were treated with doses of 100, 200 and 800 b.i.d. Dose-limiting toxicities were seen at 800 mg b.i.d.; grade 3 fatigue, grade 3 skin rash, grade 3 hyponatraemia and grade 4 hypokalaemia. Other toxicities included reversible raised creatinine (grade 2), reversible grade 3 abnormal liver function and grade 2 emesis. An 800 mg portion was investigated further in 12 patients, three of whom had MAG3 renograms. One patient with a rapid increase in creatinine on day 3 had a reversible fall in renal perfusion, with full recovery by day 14, and no changes suggestive of renal tubular damage. Further dose escalation was precluded by hypokalaemia. Seliciclib reached peak plasma concentrations between 1 and 4 h and elimination half-life was 2–5 h. Inhibition of retinoblastoma protein phosphorylation was not demonstrated in peripheral blood mononuclear cells. No objective tumour responses were noted, but disease stabilisation was recorded in eight patients; this lasted for a total of six courses (18 weeks) in a patient with ovarian cancer. PMID:17179992

  4. Cost-effectiveness of 7-day-Holter monitoring alone or in combination with transthoracic echocardiography in patients with cerebral ischemia.

    PubMed

    Mayer, Felix; Stahrenberg, Raoul; Gröschel, Klaus; Mostardt, Sarah; Biermann, Janine; Edelmann, Frank; Liman, Jan; Wasem, Jürgen; Goehler, Alexander; Wachter, Rolf; Neumann, Anja

    2013-12-01

    Prolonged Holter monitoring of patients with cerebral ischemia increases the detection rate of paroxysmal atrial fibrillation (PAF); this leads to improved antithrombotic regimens aimed at preventing recurrent ischemic strokes. The aim of this study was to compare a 7-day-Holter monitoring (7-d-Holter) alone or in combination with prior selection via transthoracic echocardiography (TTE) to a standard 24-h-Holter using a cost-utility analysis. Lifetime cost, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICER) were estimated for a cohort of patients with acute cerebral ischemia and no contraindication to oral anticoagulation. A Markov model was developed to simulate the long-term course and progression of cerebral ischemia considering the different diagnostic algorithms (24-h-Holter, 7-d-Holter, 7-d-Holter after preselection by TTE). Clinical data for these algorithms were derived from the prospective observational Find-AF study (ISRCTN 46104198). Predicted lifelong discounted costs were 33,837 for patients diagnosed by the 7-d-Holter and 33,852 by the standard 24-h-Holter. Cumulated QALYs were 3.868 for the 7-d-Holter compared to 3.844 for the 24-h-Holter. The 7-d-Holter dominated the 24-h-Holter in the base-case scenario and remained cost-effective in extensive sensitivity analysis of key input parameter with a maximum of 8,354 /QALY gained. Preselecting patients for the 7-d-Holter had no positive effect on the cost-effectiveness. A 7-d-Holter to detect PAF in patients with cerebral ischemia is cost-effective. It increases the detection which leads to improved antithrombotic regimens; therefore, it avoids recurrent strokes, saves future costs, and decreases quality of life impairment. Preselecting patients by TTE does not improve cost-effectiveness.

  5. The Sedentary Time and Activity Reporting Questionnaire (STAR-Q): Reliability and Validity Against Doubly Labeled Water and 7-Day Activity Diaries

    PubMed Central

    Csizmadi, Ilona; Neilson, Heather K.; Kopciuk, Karen A.; Khandwala, Farah; Liu, Andrew; Friedenreich, Christine M.; Yasui, Yutaka; Rabasa-Lhoret, Rémi; Bryant, Heather E.; Lau, David C. W.; Robson, Paula J.

    2014-01-01

    We determined measurement properties of the Sedentary Time and Activity Reporting Questionnaire (STAR-Q), which was designed to estimate past-month activity energy expenditure (AEE). STAR-Q validity and reliability were assessed in 102 adults in Alberta, Canada (2009–2011), who completed 14-day doubly labeled water (DLW) protocols, 7-day activity diaries on day 15, and the STAR-Q on day 14 and again at 3 and 6 months. Three-month reliability was substantial for total energy expenditure (TEE) and AEE (intraclass correlation coefficients of 0.84 and 0.73, respectively), while 6-month reliability was moderate. STAR-Q-derived TEE and AEE were moderately correlated with DLW estimates (Spearman's ρs of 0.53 and 0.40, respectively; P < 0.001), and on average, the STAR-Q overestimated TEE and AEE (median differences were 367 kcal/day and 293 kcal/day, respectively). Body mass index-, age-, sex-, and season-adjusted concordance correlation coefficients (CCCs) were 0.24 (95% confidence interval (CI): 0.07, 0.36) and 0.21 (95% CI: 0.11, 0.32) for STAR-Q-derived versus DLW-derived TEE and AEE, respectively. Agreement between the diaries and STAR-Q (metabolic equivalent-hours/day) was strongest for occupational sedentary time (adjusted CCC = 0.76, 95% CI: 0.64, 0.85) and overall strenuous activity (adjusted CCC = 0.64, 95% CI: 0.49, 0.76). The STAR-Q demonstrated substantial validity for estimating occupational sedentary time and strenuous activity and fair validity for ranking individuals by AEE. PMID:25038920

  6. [Mechanical ventilation during thoracic anesthesia].

    PubMed

    Valenza, F

    1999-05-01

    Aim of the study was to test individual mechanical and functional responses to open chest lateral decubitus during one lung ventilation. We measured dependent lung pressure volume (P-V) curves of 19 patients during supine and lateral decubitus. We found that patients characterized by high FEV1 developed greater changes in P-V curve shape than those characterized by low FEV1. Based on these results we decided to test a ventilation strategy characterized by the use of ZEEP or PEEP = 10 cm H2O applied to the dependent lung. In a preliminary set of patients stratified by FEV1 we found that PEEP deteriorated PaO2/FiO2 in patients with low FEV1, while there was a trend towards improvement in patients with high FEV1. It is possible that dependent lung PEEP counteracts atelectasias in normal lungs, while it may divert blood flow or create dead space in patients with sick and stiff lungs. We conclude that during one lung ventilation in open chest lateral decubitus, ventilatory setting need to be individually tailored.

  7. Development of a Residential Integrated Ventilation Controller

    SciTech Connect

    Staff Scientist; Walker, Iain; Sherman, Max; Dickerhoff, Darryl

    2011-12-01

    The goal of this study was to develop a Residential Integrated Ventilation Controller (RIVEC) to reduce the energy impact of required mechanical ventilation by 20percent, maintain or improve indoor air quality and provide demand response benefits. This represents potential energy savings of about 140 GWh of electricity and 83 million therms of natural gas as well as proportional peak savings in California. The RIVEC controller is intended to meet the 2008 Title 24 requirements for residential ventilation as well as taking into account the issues of outdoor conditions, other ventilation devices (including economizers), peak demand concerns and occupant preferences. The controller is designed to manage all the residential ventilation systems that are currently available. A key innovation in this controller is the ability to implement the concept of efficacy and intermittent ventilation which allows time shifting of ventilation. Using this approach ventilation can be shifted away from times of high cost or high outdoor pollution towards times when it is cheaper and more effective. Simulations, based on the ones used to develop the new residential ventilation requirements for the California Buildings Energy code, were used to further define the specific criteria and strategies needed for the controller. These simulations provide estimates of the energy, peak power and contaminant improvement possible for different California climates for the various ventilation systems. Results from a field test of the prototype controller corroborate the predicted performance.

  8. Prevention of ventilator-associated pneumonia.

    PubMed

    Lau, Arthur C W; So, H M; Tang, S L; Yeung, Alwin; Lam, S M; Yan, W W

    2015-02-01

    Ventilator-associated pneumonia is the commonest, yet mostly preventable, infection in mechanically ventilated patients. Successful control of ventilator-associated pneumonia can save hospitalisation cost, and is possible by using a multidisciplinary clinical and administrative approach. The ventilator-associated pneumonia rate should be expressed as the number of ventilator-associated pneumonia days per 1000 ventilator days to take into account the device-utilisation duration for meaningful comparison. Various strategies address the issue, including general infection control measures, body positioning, intubation and mechanical ventilation, oral and gastro-intestinal tract, endotracheal tube, airway pressure, cuff pressure, selective digestive and/or oropharyngeal decontamination, and probiotic or early antibiotic treatment, as well as overall administration at a policy level. The rationale and controversy of these approaches are discussed in this article. The authors suggest that all units treating mechanically ventilated patients should have a ventilator-associated pneumonia prevention protocol in place, and ventilator-associated pneumonia should be seriously considered as a key performance indicator in local intensive care units.

  9. Temperature of gas delivered from ventilators.

    PubMed

    Chikata, Yusuke; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

    2013-01-01

    Although heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (FIO2), and minute volume (MV). We evaluated five ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at FIO2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings. While temperature varied according to ventilators, the outlet gas temperature of ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). FIO2 and MV did not affect gas temperature. Gas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.

  10. Effect of technique and timing of tracheostomy in patients with acute traumatic spinal cord injury undergoing mechanical ventilation

    PubMed Central

    Ganuza, Javier Romero; Forcada, Angel Garcia; Gambarrutta, Claudia; De La Lastra Buigues, Elena Diez; Gonzalez, Victoria Eugenia Merlo; Fuentes, Fátima Paz; Luciani, Alejandro A.

    2011-01-01

    Objective To assess the effect of timing and techniques of tracheostomy on morbidity, mortality, and the burden of resources in patients with acute traumatic spinal cord injuries (SCIs) undergoing mechanical ventilation. Design Review of a prospectively collected database. Setting Intensive and intermediate care units of a monographic hospital for the treatment of SCI. Participants Consecutive patients admitted to the intensive care unit (ICU) during their first inpatient rehabilitation for cervical and thoracic traumatic SCI. A total of 323 patients were included: 297 required mechanical ventilation and 215 underwent tracheostomy. Outcome measures Demographic data, data relevant to the patients’ neurological injuries (level and grade of spinal cord damage), tracheostomy technique and timing, duration of mechanical ventilation, length of stay at ICU, incidence of pneumonia, incidence of perioperative and early postoperative complications, and mortality. Results Early tracheostomy (<7 days after orotracheal intubation) tracheostomy was performed in 101 patients (47%) and late (≥7 days) in 114 (53%). Surgical tracheostomy was employed in 119 cases (55%) and percutaneous tracheostomy in 96 (45%). There were 61 complications in 53 patients related to all tracheostomy procedures. Two were qualified as serious (tracheoesophageal fistula and mediastinal abscess). Other complications were mild. Bleeding was moderate in one case (late, percutaneous tracheostomy). Postoperative infection rate was low. Mortality of all causes was also low. Conclusion Early tracheostomy may have favorable effects in patients with acute traumatic SC. Both techniques, percutaneous and surgical tracheostomy, can be performed safely in the ICU. PMID:21528630

  11. Effect of technique and timing of tracheostomy in patients with acute traumatic spinal cord injury undergoing mechanical ventilation.

    PubMed

    Ganuza, Javier Romero; Garcia Forcada, Angel; Gambarrutta, Claudia; Diez De La Lastra Buigues, Elena; Merlo Gonzalez, Victoria Eugenia; Paz Fuentes, Fátima; Luciani, Alejandro A

    2011-01-01

    To assess the effect of timing and techniques of tracheostomy on morbidity, mortality, and the burden of resources in patients with acute traumatic spinal cord injuries (SCls) undergoing mechanical ventilation. Review of a prospectively collected database. Intensive and intermediate care units of a monographic hospital for the treatment of SCI. Consecutive patients admitted to the intensive care unit (ICU) during their first inpatient rehabilitation for cervical and thoracic traumatic SCI. A total of 323 patients were included: 297 required mechanical ventilation and 215 underwent tracheostomy. Demographic data, data relevant to the patients' neurological injuries (level and grade of spinal cord damage), tracheostomy technique and timing, duration of mechanical ventilation, length of stay at ICU, incidence of pneumonia, incidence of perioperative and early postoperative complications, and mortality. Early tracheostomy (<7 days after orotracheal intubation) tracheostomy was performed in 101 patients (47%) and late (> or = 7 days) in 114 (53%). Surgical tracheostomy was employed in 119 cases (55%) and percutaneous tracheostomy in 96 (45%). There were 61 complications in 53 patients related to all tracheostomy procedures. Two were qualified as serious (tracheoesophageal fistula and mediastinal abscess). Other complications were mild. Bleeding was moderate in one case (late, percutaneous tracheostomy). Postoperative infection rate was low. Mortality of all causes was also low. Early tracheostomy may have favorable effects in patients with acute traumatic SC. Both techniques, percutaneous and surgical tracheostomy, can be performed safely in the ICU.

  12. Latching overcurrent circuit breaker

    NASA Technical Reports Server (NTRS)

    Moore, M. L.

    1970-01-01

    Circuit breaker consists of a preset current amplitude sensor, and a lamp-photo-resistor combination in a feedback arrangement which energizes a power switching relay. The ac input power is removed from the load at predetermined current amplitudes.

  13. High temperature circuit breaker

    NASA Technical Reports Server (NTRS)

    Edwards, R. N.; Travis, E. F.

    1970-01-01

    Alternating current circuit breaker is suitable for reliable long-term service at 1000 deg F in the vacuum conditions of outer space. Construction materials are resistant to nuclear radiation and vacuum welding. Service test conditions and results are given.

  14. Generator circuit breaker retrofit

    SciTech Connect

    Dayton, L.P.

    1995-12-31

    This paper will discuss the economic considerations, the development from concept to installation, benefits realized and the operational history of the generator circuit breaker retrofit project at Wanapum and Priest Rapids Dams, Grant County Public Utility District, Washington.

  15. Cell types, circuits, computation.

    PubMed

    Azeredo da Silveira, Rava; Roska, Botond

    2011-10-01

    How does the connectivity of a neuronal circuit, together with the individual properties of the cell types that take part in it, result in a given computation? We examine this question in the context of retinal circuits. We suggest that the retina can be viewed as a parallel assemblage of many small computational devices, highly stereotypical and task-specific circuits afferent to a given ganglion cell type, and we discuss some rules that govern computation in these devices. Multi-device processing in retina poses conceptual problems when it is contrasted with cortical processing. We lay out open questions both on processing in retinal circuits and on implications for cortical processing of retinal inputs.

  16. Particle deposition in ventilation ducts

    SciTech Connect

    Sippola, Mark Raymond

    2002-09-01

    Exposure to airborne particles is detrimental to human health and indoor exposures dominate total exposures for most people. The accidental or intentional release of aerosolized chemical and biological agents within or near a building can lead to exposures of building occupants to hazardous agents and costly building remediation. Particle deposition in heating, ventilation and air-conditioning (HVAC) systems may significantly influence exposures to particles indoors, diminish HVAC performance and lead to secondary pollutant release within buildings. This dissertation advances the understanding of particle behavior in HVAC systems and the fates of indoor particles by means of experiments and modeling. Laboratory experiments were conducted to quantify particle deposition rates in horizontal ventilation ducts using real HVAC materials. Particle deposition experiments were conducted in steel and internally insulated ducts at air speeds typically found in ventilation ducts, 2-9 m/s. Behaviors of monodisperse particles with diameters in the size range 1-16 μm were investigated. Deposition rates were measured in straight ducts with a fully developed turbulent flow profile, straight ducts with a developing turbulent flow profile, in duct bends and at S-connector pieces located at duct junctions. In straight ducts with fully developed turbulence, experiments showed deposition rates to be highest at duct floors, intermediate at duct walls, and lowest at duct ceilings. Deposition rates to a given surface increased with an increase in particle size or air speed. Deposition was much higher in internally insulated ducts than in uninsulated steel ducts. In most cases, deposition in straight ducts with developing turbulence, in duct bends and at S-connectors at duct junctions was higher than in straight ducts with fully developed turbulence. Measured deposition rates were generally higher than predicted by published models. A model incorporating empirical equations based on the

  17. Integrated Optical Circuits

    DTIC Science & Technology

    1974-12-31

    are suit- able for use with Si-doped GaAs-AlGaAs integrated lasers and with integrated electroabsorption detectors and modulators. Integrated ...characterized. These structures are quite attractive for use as sources in GaAs-based monolithic integrated opti- cal circuits. Threshold current...optical waveguide is an important element in the fabrication of a monolithic integrated optical circuit. One such structure, which utilizes the "twin

  18. Printed Circuit Board Inspection.

    DTIC Science & Technology

    1981-11-25

    8217, but copper is etched off a smoothly plated board to form the ’printed circuit.’ The etching, as the name implies, leaves a three- 6 Figure 3-2...e.g., dust on the light- plate used to transfer the board design from the artwork negative). The information output must be verifiable -. if only to...Carnegie-Mellon University 00 PRINTED CIRCUIT BOARD INSPECTION W ~Robert Thibadeau -= The Robotics Institute Carnegie-Mellon University Pittsburgh

  19. Power supply conditioning circuit

    NASA Technical Reports Server (NTRS)

    Primas, Lori E. (Inventor); Loveland, Rohan C. (Inventor)

    1988-01-01

    A conditioning circuit is provided with a constant current diode in series with a zener diode, the former having a high dynamic impedance and the latter a low dynamic impedance. The constant current diode can receive an input voltage with PARD. In conjunction with the zener diode fixed to a ground, a voltage divider is provided which can give an output voltage whose PARD was significantly reduced. The conditioning circuit is effective down to dc.

  20. Quantum circuits for cryptanalysis

    NASA Astrophysics Data System (ADS)

    Amento, Brittanney Jaclyn

    Finite fields of the form F2 m play an important role in coding theory and cryptography. We show that the choice of how to represent the elements of these fields can have a significant impact on the resource requirements for quantum arithmetic. In particular, we show how the Gaussian normal basis representations and "ghost-bit basis" representations can be used to implement inverters with a quantum circuit of depth O(mlog(m)). To the best of our knowledge, this is the first construction with subquadratic depth reported in the literature. Our quantum circuit for the computation of multiplicative inverses is based on the Itoh-Tsujii algorithm which exploits the property that, in a normal basis representation, squaring corresponds to a permutation of the coefficients. We give resource estimates for the resulting quantum circuit for inversion over binary fields F2 m based on an elementary gate set that is useful for fault-tolerant implementation. Elliptic curves over finite fields F2 m play a prominent role in modern cryptography. Published quantum algorithms dealing with such curves build on a short Weierstrass form in combination with affine or projective coordinates. In this thesis we show that changing the curve representation allows a substantial reduction in the number of T-gates needed to implement the curve arithmetic. As a tool, we present a quantum circuit for computing multiplicative inverses in F2m in depth O(m log m) using a polynomial basis representation, which may be of independent interest. Finally, we change our focus from the design of circuits which aim at attacking computational assumptions on asymmetric cryptographic algorithms to the design of a circuit attacking a symmetric cryptographic algorithm. We consider a block cipher, SERPENT, and our design of a quantum circuit implementing this cipher to be used for a key attack using Grover's algorithm as in [18]. This quantum circuit is essential for understanding the complexity of Grover's algorithm.

  1. Overriding Faulty Circuit Breakers

    NASA Technical Reports Server (NTRS)

    Robbins, Richard L.; Pierson, Thomas E.

    1987-01-01

    Retainer keeps power on in emergency. Simple mechanical device attaches to failed aircraft-type push/pull circuit breaker to restore electrical power temporarily until breaker replaced. Device holds push/pull button in closed position; unnecessary for crewmember to hold button in position by continual finger pressure. Sleeve and plug hold button in, overriding mechanical failure in circuit breaker. Windows in sleeve show button position.

  2. Overriding Faulty Circuit Breakers

    NASA Technical Reports Server (NTRS)

    Robbins, Richard L.; Pierson, Thomas E.

    1987-01-01

    Retainer keeps power on in emergency. Simple mechanical device attaches to failed aircraft-type push/pull circuit breaker to restore electrical power temporarily until breaker replaced. Device holds push/pull button in closed position; unnecessary for crewmember to hold button in position by continual finger pressure. Sleeve and plug hold button in, overriding mechanical failure in circuit breaker. Windows in sleeve show button position.

  3. Color Coding of Circuit Quantities in Introductory Circuit Analysis Instruction

    ERIC Educational Resources Information Center

    Reisslein, Jana; Johnson, Amy M.; Reisslein, Martin

    2015-01-01

    Learning the analysis of electrical circuits represented by circuit diagrams is often challenging for novice students. An open research question in electrical circuit analysis instruction is whether color coding of the mathematical symbols (variables) that denote electrical quantities can improve circuit analysis learning. The present study…

  4. Heterogeneous photonic integrated circuits

    NASA Astrophysics Data System (ADS)

    Fang, Alexander W.; Fish, Gregory; Hall, Eric

    2012-01-01

    Photonic Integrated Circuits (PICs) have been dichotomized into circuits with high passive content (silica and silicon PLCs) and high active content (InP tunable lasers and transceivers) due to the trade-off in material characteristics used within these two classes. This has led to restrictions in the adoption of PICs to systems in which only one of the two classes of circuits are required to be made on a singular chip. Much work has been done to create convergence in these two classes by either engineering the materials to achieve the functionality of both device types on a single platform, or in epitaxial growth techniques to transfer one material to the next, but have yet to demonstrate performance equal to that of components fabricated in their native substrates. Advances in waferbonding techniques have led to a new class of heterogeneously integrated photonic circuits that allow for the concurrent use of active and passive materials within a photonic circuit, realizing components on a transferred substrate that have equivalent performance as their native substrate. In this talk, we review and compare advances made in heterogeneous integration along with demonstrations of components and circuits enabled by this technology.

  5. Fluid balance and length of mechanical ventilation in children admitted to a single Pediatric Intensive Care Unit.

    PubMed

    Vidal, Solange; Pérez, Augusto; Eulmesekian, Pablo

    2016-08-01

    Associations between cumulative fluid balance and a prolonged duration of assisted mechanical ventilation have been described in adults. The aim of this study was to evaluate whether fluid balance in the first 48 hours of assisted mechanical ventilation initiation was associated with a prolonged duration of this process among children in the Pediatric Intensive Care Unit (PICU). Retrospective cohort of patients in the PICU o, Hospital Italiano de Buenos Aires, between 1/1/2010 and 6/30/2012. Balance was calculated in percentage of body weight; prolonged mechanical ventilation was defined as >7 days, and confounders were registered. Univariate and multivariate analyses were performed. Two hundred and forty-nine patients were mechanically ventilated for over 48 hours; 163 were included in the study. Balance during the first 48 hours of mechanical ventilation was 5.7% ± 5.86; 82 patients (50.3%) were on mechanical ventilation for more than 7 days. Age 〈 4 years old (OR 3.21, 95% CI 1.38-7.48, p 0.007), respiratory disease (OR 4.94, 95% CI 1.51-16.10, p 0.008), septic shock (OR 4.66, 95% CI 1.10-19.65, p 0.036), Pediatric Logistic Organ Dysfunction (PELOD) 〉 10 (OR 2.44, 95% CI 1.234.85, p 0.011), and positive balance 〉 13% (OR 4.02, 95% CI 1.08-15.02, p 0.038) were associated with prolonged mechanical ventilation. The multivariate model resulted in an OR 2.58, 95% CI: 1.17-5.58, p= 0.018 for PELOD 〉 10, and an OR 3.7, 95% CI: 0.91-14.94, p= 0.066 for positive balance 〉 13%. Regarding prolonged mechanical ventilation, the multivariate model showed an independent association with organ dysfunction (PELOD 〉 10) and a trend towards an association with positive balance 〉 13%. Sociedad Argentina de Pediatría.

  6. Mechanical ventilation: what have we learned?

    PubMed

    Fenstermacher, Denise; Hong, Dennis

    2004-01-01

    Mechanical ventilation is the second most frequently performed therapeutic intervention after treatment for cardiac arrhythmias in intensive care units today. Countless lives have been saved with its use despite being associated with a greater than 30% in-hospital mortality rate. As life expectancies increase and people with chronic illnesses survive longer, artificial support with mechanical ventilation is also expected to rise. In one survey, over half of senior internal medicine residents reported their training on mechanical ventilation as inadequate, whereas the majority of critical care nurses reported having received no formal education on its use. Technological advances resulting in the availability of sleeker ventilators with graphic waveform displays and new modes of ventilation have challenged the bedside clinicians to incorporate this new data along with evidenced-based research into their daily practice. A review of current thoughts on mechanical ventilation and weaning is presented.

  7. Early Rehabilitation Therapy Is Beneficial for Patients With Prolonged Mechanical Ventilation After Coronary Artery Bypass Surgery.

    PubMed

    Dong, Zehua; Yu, Bangxu; Zhang, Quanfang; Pei, Haitao; Xing, Jinyan; Fang, Wei; Sun, Yunbo; Song, Zhen

    2016-01-01

    We investigated the effects of early rehabilitation therapy on prolonged mechanically ventilated patients after coronary artery bypass surgery (CABG).A total of 106 patients who underwent CABG between June 2012 and May 2015 were enrolled and randomly assigned into an early rehabilitation group (53 cases) and a control group (53 cases). The rehabilitation therapy consisted of 6 steps including head up, transferring from supination to sitting, sitting on the edge of bed, sitting in a chair, transferring from sitting to standing, and walking along a bed. The patients received rehabilitation therapy in the intensive care unit (ICU) after CABG in the early rehabilitation group. The control group patients received rehabilitation therapy after leaving the ICU.The results showed that the early rehabilitation therapy could significantly decrease the duration of mechanical ventilation (early rehabilitation group: 8.1 ± 3.3 days; control group: 13.9 ± 4.1 days, P < 0.01), hospital stay (early rehabilitation group: 22.0 ± 3.8 days; control group: 29.1 ± 4.6 days, P < 0.01), and ICU stay (early rehabilitation group: 11.7 ± 3.2 days; control group: 18.3 ± 4.2 days, P < 0.01) for patients requiring more than 72 hours prolonged mechanical ventilation. The results of Kaplan-Meier analysis showed that the proportions of patients remaining on mechanical ventilation in the early rehabilitation group were larger than that in the control group after 7 days of rehabilitation therapy (logrank test: P < 0.01). The results provide evidence for supporting the application of early rehabilitation therapy in patients requiring prolonged mechanical ventilation after CABG.

  8. Activation of K{sup +} channels and Na{sup +}/K{sup +} ATPase prevents aortic endothelial dysfunction in 7-day lead-treated rats

    SciTech Connect

    Fiorim, Jonaina; Ribeiro Júnior, Rogério Faustino; Azevedo, Bruna Fernades; Simões, Maylla Ronacher; Padilha, Alessandra Simão; Stefanon, Ivanita; Alonso, Maria Jesus; Salaices, Mercedes; Vassallo, Dalton Valentim

    2012-07-01

    Seven day exposure to a low concentration of lead acetate increases nitric oxide bioavailability suggesting a putative role of K{sup +} channels affecting vascular reactivity. This could be an adaptive mechanism at the initial stages of toxicity from lead exposure due to oxidative stress. We evaluated whether lead alters the participation of K{sup +} channels and Na{sup +}/K{sup +}-ATPase (NKA) on vascular function. Wistar rats were treated with lead (1st dose 4 μg/100 g, subsequent doses 0.05 μg/100 g, im, 7 days) or vehicle. Lead treatment reduced the contractile response of aortic rings to phenylephrine (PHE) without changing the vasodilator response to acetylcholine (ACh) or sodium nitroprusside (SNP). Furthermore, this treatment increased basal O{sub 2}{sup −} production, and apocynin (0.3 μM), superoxide dismutase (150 U/mL) and catalase (1000 U/mL) reduced the response to PHE only in the treated group. Lead also increased aortic functional NKA activity evaluated by K{sup +}-induced relaxation curves. Ouabain (100 μM) plus L-NAME (100 μM), aminoguanidine (50 μM) or tetraethylammonium (TEA, 2 mM) reduced the K{sup +}-induced relaxation only in lead-treated rats. When aortic rings were precontracted with KCl (60 mM/L) or preincubated with TEA (2 mM), 4-aminopyridine (4-AP, 5 mM), iberiotoxin (IbTX, 30 nM), apamin (0.5 μM) or charybdotoxin (0.1 μM), the ACh-induced relaxation was more reduced in the lead-treated rats. Additionally, 4-AP and IbTX reduced the relaxation elicited by SNP more in the lead-treated rats. Results suggest that lead treatment promoted NKA and K{sup +} channels activation and these effects might contribute to the preservation of aortic endothelial function against oxidative stress. -- Highlights: ► Increased free radicals production ► Increased Na{sup +}/K{sup +} ATPase activity ► Promotes activation of the K{sup +} channels and reduced vascular reactivity ► These effects preserve endothelial function against oxidative

  9. Cytotoxic effects in 3T3-L1 mouse and WI-38 human fibroblasts following 72 hour and 7 day exposures to commercial silica nanoparticles

    SciTech Connect

    Stępnik, Maciej; Arkusz, Joanna; Smok-Pieniążek, Anna; Bratek-Skicki, Anna; Salvati, Anna; Lynch, Iseult; Dawson, Kenneth A.; Gromadzińska, Jolanta; De Jong, Wim H.; Rydzyński, Konrad

    2012-08-15

    The potential toxic effects in murine (3T3-L1) and human (WI-38) fibroblast cell lines of commercially available silica nanoparticles (NPs), Ludox CL (nominal size 21 nm) and CL-X (nominal size of 30 nm) were investigated with particular attention to the effect over long exposure times (the tests were run after 72 h exposure up to 7 days). These two formulations differed in physico-chemical properties and showed different stabilities in the cell culture medium used for the experiments. Ludox CL silica NPs were found to be cytotoxic only at the higher concentrations to the WI-38 cells (WST-1 and LDH assays) but not to the 3T3-L1 cells, whereas the Ludox CL-X silica NPs, which were less stable over the 72 h exposure, were cytotoxic to both cell lines in both assays. In the clonogenic assay both silica NPs induced a concentration dependent decrease in the surviving fraction of 3T3-L1 cells, with the Ludox CL-X silica NPs being more cytotoxic. Cell cycle analysis showed a trend indicating alterations in both cell lines at different phases with both silica NPs tested. Buthionine sulfoximine (γ-glutamylcysteine synthetase inhibitor) combined with Ludox CL-X was found to induce a strong decrease in 3T3-L1 cell viability which was not observed for the WI-38 cell line. This study clearly indicates that longer exposure studies may give important insights on the impact of nanomaterials on cells. However, and especially when investigating nanoparticle effects after such long exposure, it is fundamental to include a detailed physico-chemical characterization of the nanoparticles and their dispersions over the time scale of the experiment, in order to be able to interpret eventual impacts on cells. -- Highlights: ► Ludox CL silica NPs are cytotoxic to WI-38 fibroblasts but not to 3T3-L1 fibroblasts. ► Ludox CL-X silica NPs are cytotoxic to both cell lines. ► In clonogenic assay both silica NPs induce cytotoxicity, higher for CL-X silica. ► Cell cycle analysis shows

  10. [Home mechanical ventilation: Invasive and noninvasive ventilation therapy for chronic respiratory failure].

    PubMed

    Huttmann, S E; Storre, J H; Windisch, W

    2015-06-01

    Home mechanical ventilation represents a valuable therapeutic option to improve alveolar ventilation in patients with chronic respiratory failure. For this purpose both invasive ventilation via tracheostomy and noninvasive ventilation via facemasks are available. The primary goal of home mechanical ventilation is a reduction of symptoms, improvement of quality of life and in many cases reduction of mortality. Elective establishment of home mechanical ventilation is typically provided for noninvasive ventilation in respect to clinical symptoms and partial pressure of carbon dioxide depending on the underlying disease. However, invasive mechanical ventilation is increasingly being used to continue ventilatory support in polymorbid patients following unsuccessful weaning. Recommendations and guidelines have been published by the German Respiratory Society (DGP).

  11. Circuit simulation: some humbling thoughts

    SciTech Connect

    Wendt, Manfred; /Fermilab

    2006-01-01

    A short, very personal note on circuit simulation is presented. It does neither include theoretical background on circuit simulation, nor offers an overview of available software, but just gives some general remarks for a discussion on circuit simulator needs in context to the design and development of accelerator beam instrumentation circuits and systems.

  12. Vibration Damping Circuit Card Assembly

    NASA Technical Reports Server (NTRS)

    Hunt, Ronald Allen (Inventor)

    2016-01-01

    A vibration damping circuit card assembly includes a populated circuit card having a mass M. A closed metal container is coupled to a surface of the populated circuit card at approximately a geometric center of the populated circuit card. Tungsten balls fill approximately 90% of the metal container with a collective mass of the tungsten balls being approximately (0.07) M.

  13. Exchange circuits for FASTBUS slaves

    SciTech Connect

    Bratskii, A.A.; Matseev, M.Y.; Rybakov, V.G.

    1985-09-01

    This paper describes general-purpose circuits for FASTBUS interfacing of the functional part of a slave device. The circuits contain buffered receivers and transmitters, addressrecognition and data-transfer logic, and the required control/status registers. The described circuits are implemented with series-K500 integrated circuits.

  14. Superconducting flux flow digital circuits

    DOEpatents

    Hietala, Vincent M.; Martens, Jon S.; Zipperian, Thomas E.

    1995-01-01

    A NOR/inverter logic gate circuit and a flip flop circuit implemented with superconducting flux flow transistors (SFFTs). Both circuits comprise two SFFTs with feedback lines. They have extremely low power dissipation, very high switching speeds, and the ability to interface between Josephson junction superconductor circuits and conventional microelectronics.

  15. Superconducting flux flow digital circuits

    DOEpatents

    Hietala, V.M.; Martens, J.S.; Zipperian, T.E.

    1995-02-14

    A NOR/inverter logic gate circuit and a flip flop circuit implemented with superconducting flux flow transistors (SFFTs) are disclosed. Both circuits comprise two SFFTs with feedback lines. They have extremely low power dissipation, very high switching speeds, and the ability to interface between Josephson junction superconductor circuits and conventional microelectronics. 8 figs.

  16. Performance of Portable Ventilators at Temperature Extremes

    DTIC Science & Technology

    2015-03-30

    shipped and stored at ambient conditions. The effect of storage at hot and cold temperature extremes on ventilator performance is unknown. We evaluated...The effect of storage at hot and cold temperature extremes on ventilator performance is unknown. We evaluated three portable ventilators currently...operated immediately after 30 minutes of acclimation to room temperature but displayed either a “battery too hot ” or “battery too cold” alert at

  17. Single-lung ventilation in pediatric anesthesia.

    PubMed

    Choudhry, Dinesh K

    2005-12-01

    Single-lung ventilation is requested for an increasing spectrum of surgical procedures in infants and children. A clear understanding of the physiology of single-lung ventilation, the techniques of lung separation, and the technical skill necessary to apply these techniques are essential for an anesthesiologist practicing thoracic anesthesia. This article focuses on various devices available for single-lung ventilation in the pediatric age group, the relevant respiratory physiology, and the strategies that optimize oxygenation during one-lung anesthesia.

  18. Airway Microbial Community Turnover Differs by BPD Severity in Ventilated Preterm Infants.

    PubMed

    Wagner, Brandie D; Sontag, Marci K; Harris, J Kirk; Miller, Joshua I; Morrow, Lindsey; Robertson, Charles E; Stephens, Mark; Poindexter, Brenda B; Abman, Steven H; Mourani, Peter M

    2017-01-01

    Preterm birth exposes the developing lung to an environment with direct exposure to bacteria, often facilitated by endotracheal intubation. Despite evidence linking bacterial infections to the pathogenesis of bronchopulmonary dysplasia (BPD), systematic studies of airway microbiota are limited. The objective was to identify specific patterns of the early respiratory tract microbiome from tracheal aspirates of mechanically ventilated preterm infants that are associated with the development and severity of BPD. Infants with gestational age ≤34 weeks, and birth weight 500-1250g were prospectively enrolled. Mechanically ventilated infants had tracheal aspirate samples collected at enrollment, 7, 14, and 21 days of age. BPD was determined by modified NIH criteria with oxygen reduction tests; infants without BPD were excluded due to low numbers. Aspirates were processed for bacterial identification by 16S rRNA sequencing, and bacterial load by qPCR. Cross-sectional analysis was performed using 7 day samples and longitudinal analysis was performed from subjects with at least 2 aspirates. Microbiome analysis was performed on tracheal aspirates from 152 infants (51, 49, and 52 with mild, moderate, and severe BPD, respectively). Seventy-nine of the infants were included in the cross-sectional analysis and 94 in the longitudinal. Shannon Diversity, bacterial load, and relative abundance of individual taxa were not strongly associated with BPD status. Longitudinal analysis revealed that preterm infants who eventually developed severe BPD exhibited greater bacterial community turnover with age, acquired less Staphylococcus in the first days after birth, and had higher initial relative abundance of Ureaplasma. In conclusion, longitudinal changes in the airway microbial communities of mechanically ventilated preterm infants may be associated with BPD severity, whereas cross-sectional analysis of airway ecology at 7 days of age did not reveal an association with BPD severity

  19. Airway Microbial Community Turnover Differs by BPD Severity in Ventilated Preterm Infants

    PubMed Central

    Wagner, Brandie D.; Sontag, Marci K.; Harris, J. Kirk; Miller, Joshua I.; Morrow, Lindsey; Robertson, Charles E.; Stephens, Mark; Poindexter, Brenda B.; Abman, Steven H.; Mourani, Peter M.

    2017-01-01

    Preterm birth exposes the developing lung to an environment with direct exposure to bacteria, often facilitated by endotracheal intubation. Despite evidence linking bacterial infections to the pathogenesis of bronchopulmonary dysplasia (BPD), systematic studies of airway microbiota are limited. The objective was to identify specific patterns of the early respiratory tract microbiome from tracheal aspirates of mechanically ventilated preterm infants that are associated with the development and severity of BPD. Infants with gestational age ≤34 weeks, and birth weight 500–1250g were prospectively enrolled. Mechanically ventilated infants had tracheal aspirate samples collected at enrollment, 7, 14, and 21 days of age. BPD was determined by modified NIH criteria with oxygen reduction tests; infants without BPD were excluded due to low numbers. Aspirates were processed for bacterial identification by 16S rRNA sequencing, and bacterial load by qPCR. Cross-sectional analysis was performed using 7 day samples and longitudinal analysis was performed from subjects with at least 2 aspirates. Microbiome analysis was performed on tracheal aspirates from 152 infants (51, 49, and 52 with mild, moderate, and severe BPD, respectively). Seventy-nine of the infants were included in the cross-sectional analysis and 94 in the longitudinal. Shannon Diversity, bacterial load, and relative abundance of individual taxa were not strongly associated with BPD status. Longitudinal analysis revealed that preterm infants who eventually developed severe BPD exhibited greater bacterial community turnover with age, acquired less Staphylococcus in the first days after birth, and had higher initial relative abundance of Ureaplasma. In conclusion, longitudinal changes in the airway microbial communities of mechanically ventilated preterm infants may be associated with BPD severity, whereas cross-sectional analysis of airway ecology at 7 days of age did not reveal an association with BPD severity

  20. 30 CFR 57.8532 - Opening and closing ventilation doors.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Opening and closing ventilation doors. 57.8532... Ventilation Underground Only § 57.8532 Opening and closing ventilation doors. When ventilation control doors...-establish normal ventilation to working places....

  1. 30 CFR 57.8532 - Opening and closing ventilation doors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Opening and closing ventilation doors. 57.8532... Ventilation Underground Only § 57.8532 Opening and closing ventilation doors. When ventilation control doors...-establish normal ventilation to working places....

  2. 30 CFR 57.8532 - Opening and closing ventilation doors.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Opening and closing ventilation doors. 57.8532... Ventilation Underground Only § 57.8532 Opening and closing ventilation doors. When ventilation control doors...-establish normal ventilation to working places....

  3. 46 CFR 153.312 - Ventilation system standards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ventilation system must not allow air to stagnate in any part of a ventilated space. (g) A ventilation system... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS... Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space...

  4. 46 CFR 153.312 - Ventilation system standards.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ventilation system must not allow air to stagnate in any part of a ventilated space. (g) A ventilation system... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS... Handling Space Ventilation § 153.312 Ventilation system standards. A cargo handling space...

  5. 30 CFR 75.330 - Face ventilation control devices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Face ventilation control devices. 75.330... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.330 Face ventilation control devices. (a) Brattice cloth, ventilation tubing and other face ventilation control devices shall...

  6. 30 CFR 75.330 - Face ventilation control devices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Face ventilation control devices. 75.330... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.330 Face ventilation control devices. (a) Brattice cloth, ventilation tubing and other face ventilation control devices shall...

  7. 30 CFR 75.330 - Face ventilation control devices.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Face ventilation control devices. 75.330... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.330 Face ventilation control devices. (a) Brattice cloth, ventilation tubing and other face ventilation control devices shall...

  8. 30 CFR 75.330 - Face ventilation control devices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Face ventilation control devices. 75.330... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.330 Face ventilation control devices. (a) Brattice cloth, ventilation tubing and other face ventilation control devices shall...

  9. 30 CFR 75.330 - Face ventilation control devices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Face ventilation control devices. 75.330... SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.330 Face ventilation control devices. (a) Brattice cloth, ventilation tubing and other face ventilation control devices shall...

  10. [Principles and function of mechanical ventilation: classification and modes of ventilators].

    PubMed

    Kelbel, C; Huntemann, M; Lorenz, J

    2006-04-01

    A spectrum of diseases is associated with the necessity for partial or total support of pulmonary ventilation. The insight into the function of ventilators and their modes reduces the spectrum of ventilatory support to a few basic principles. The knowledge enables the pulmonary intensivist to adapt mechanical ventilation to the individual patient's needs. This overview describes the technical aspects of mechanical ventilation and summarizes the variety of specific modes implied.

  11. Initial ventilator settings for critically ill patients.

    PubMed

    Kilickaya, Oguz; Gajic, Ognjen

    2013-03-12

    The lung-protective mechanical ventilation strategy has been standard practice for management of acute respiratory distress syndrome (ARDS) for more than a decade. Observational data, small randomized studies and two recent systematic reviews suggest that lung protective ventilation is both safe and potentially beneficial in patients who do not have ARDS at the onset of mechanical ventilation. Principles of lung-protective ventilation include: a) prevention of volutrauma (tidal volume 4 to 8 ml/kg predicted body weight with plateau pressure<30 cmH2O); b) prevention of atelectasis (positive end-expiratory pressure≥5 cmH2O, as needed recruitment maneuvers); c) adequate ventilation (respiratory rate 20 to 35 breaths per minute); and d) prevention of hyperoxia (titrate inspired oxygen concentration to peripheral oxygen saturation (SpO2) levels of 88 to 95%). Most patients tolerate lung protective mechanical ventilation well without the need for excessive sedation. Patients with a stiff chest wall may tolerate higher plateau pressure targets (approximately 35 cmH2O) while those with severe ARDS and ventilator asynchrony may require a short-term neuromuscular blockade. Given the difficulty in timely identification of patients with or at risk of ARDS and both the safety and potential benefit in patients without ARDS, lung-protective mechanical ventilation is recommended as an initial approach to mechanical ventilation in both perioperative and critical care settings.

  12. Endotoxemia accelerates diaphragm dysfunction in ventilated rabbits.

    PubMed

    Yang, Yi; Yu, Tao; Pan, Chun; Longhini, Federico; Liu, Ling; Huang, Yingzi; Guo, Fengmei; Qiu, Haibo

    2016-12-01

    Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility. After anesthesia and tracheostomy, 25 invasively monitored and mechanically ventilated New Zealand white rabbits were randomized to control (n = 5), controlled mechanical ventilation (CMV) (n = 5), pressure support ventilation (PSV; n = 5), CMV or PSV with LPS-induced endotoxemia (CMV-LPS and PSV-LPS, respectively; n = 5 for each). Rabbits were anesthetized and ventilated for 24 h, except the control rabbits (30 min). Diaphragmatic contractility was evaluated using neuromechanical and neuroventilatory efficiency. We evaluated the following at the end of the protocol: (1) diaphragm microcirculation; (2) lipid accumulation; and (3) diaphragm muscular fibers structure. Diaphragm contractility, microcirculation, lipid accumulation, and fiber structures were severely compromised in endotoxemic animals after 24 h compared to nonendotoxemic rabbits. Moreover, a slight but significant increase in lipid accumulation was observed in CMV and PSV groups compared with controls (P < 0.05). Endotoxemia accelerates the diaphragm dysfunction process in ventilated rabbits, affects the microcirculation, and results in diaphragmatic lipid accumulation and contractility impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Lung-protective ventilation in neonatology.

    PubMed

    van Kaam, Anton

    2011-01-01

    Ventilator-induced lung injury (VILI) is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD) and is primarily caused by overdistension (volutrauma) and repetitive opening and collapse (atelectrauma) of terminal lung units. Lung-protective ventilation should therefore aim to reduce tidal volumes, and recruit and stabilize atelectatic lung units (open lung ventilation strategy). This review will summarize the available evidence on lung-protective ventilation in neonatology, discussing both high-frequency ventilation (HFV) and positive pressure ventilation (PPV). It shows that HFV does not appear to have a clear benefit over PPV, although most studies failed to apply a true open lung ventilation strategy during HFV. The evidence on the optimal tidal volume, positive end-expiratory pressure and the role for lung recruitment during lung-protective PPV is extremely limited. Volume-targeted ventilation seems to be a promising mode in terms of lung protection, but more studies are needed. Due to the lack of convincing evidence, lung-protective ventilation and modes seem to be implemented in daily clinical practice at a slow pace.

  14. [VENTILOP survey. Survey in peroperative mechanical ventilation].

    PubMed

    Fischer, F; Collange, O; Mahoudeau, G; Simon, M; Moussa, H; Thibaud, A; Steib, A; Pottecher, T; Mertes, M

    2014-06-01

    Mechanical ventilation can initiate ventilator-associated lung injury and postoperative pulmonary complications. The aim of this study was to evaluate (1) how mechanical ventilation was comprehended by anaesthetists (physician and nurses) and (2) the need for educational programs. A computing questionnary was sent by electronic-mail to the entire anaesthetist from Alsace region in France (297 physicians), and to a pool of 99 nurse anaesthetists. Mechanical ventilation during anaesthesia was considered as optimized when low tidal volume (6-8mL) of ideal body weight was associated with positive end expiratory pressure, FiO2 less than 50%, I/E adjustment and recruitment maneuvers. The participation rate was 50.5% (172 professionals). Only 2.3% of professionals used the five parameters for optimized ventilation. Majority of professionals considered that mechanical ventilation adjustment influenced the patients' postoperative outcome. Majority of the professionals asked for a specific educational program in the field of mechanical ventilation. Only 2.3% of professionals optimized mechanical ventilation during anaesthesia. Guidelines and specific educational programs in the field of mechanical ventilation are widely expected. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  15. Effect of enhanced ultraviolet germicidal irradiation in the heating ventilation and air conditioning system on ventilator-associated pneumonia in a neonatal intensive care unit.

    PubMed

    Ryan, R M; Wilding, G E; Wynn, R J; Welliver, R C; Holm, B A; Leach, C L

    2011-09-01

    The objective of this study was to test the hypothesis that enhanced ultraviolet germicidal irradiation (eUVGI) installed in our neonatal intensive care unit (NICU) heating ventilation and air conditioning system (HVAC) would decrease HVAC and NICU environment microbes, tracheal colonization and ventilator-associated pneumonia (VAP). The study was designed as a prospective interventional pre- and post-single-center study. University-affiliated Regional Perinatal Center NICU. Intubated patients in the NICU were evaluated for colonization, and a high-risk sub-population of infants <30 weeks gestation ventilated for ≥ 14 days was studied for VAP. eUVGI was installed in the NICU's remote HVACs. The HVACs, NICU environment and intubated patients' tracheas were cultured pre- and post-eUVGI for 12 months. The high-risk patients were studied for VAP (positive bacterial tracheal culture, increased ventilator support, worsening chest radiograph and ≥ 7 days of antibiotics). Pseudomonas, Klebsiella, Serratia, Acinetobacter, Staphylococcus aureus and Coagulase-negative Staphylococcus species were cultured from all sites. eUVGI significantly decreased HVAC organisms (baseline 500,000 CFU cm(-2); P=0.015) and NICU environmental microbes (P<0.0001). Tracheal microbial loads decreased 45% (P=0.004), and fewer patients became colonized. VAP in the high-risk cohort fell from 74% (n=31) to 39% (n=18), P=0.04. VAP episodes per patient decreased (Control: 1.2 to eUVGI: 0.4; P=0.004), and antibiotic usage was 62% less (P=0.013). eUVGI decreased HVAC microbial colonization and was associated with reduced NICU environment and tracheal microbial colonization. Significant reductions in VAP and antibiotic use were also associated with eUVGI in this single-center study. Large randomized multicenter trials are needed.

  16. Low latency asynchronous interface circuits

    DOEpatents

    Sadowski, Greg

    2017-06-20

    In one form, a logic circuit includes an asynchronous logic circuit, a synchronous logic circuit, and an interface circuit coupled between the asynchronous logic circuit and the synchronous logic circuit. The asynchronous logic circuit has a plurality of asynchronous outputs for providing a corresponding plurality of asynchronous signals. The synchronous logic circuit has a plurality of synchronous inputs corresponding to the plurality of asynchronous outputs, a stretch input for receiving a stretch signal, and a clock output for providing a clock signal. The synchronous logic circuit provides the clock signal as a periodic signal but prolongs a predetermined state of the clock signal while the stretch signal is active. The asynchronous interface detects whether metastability could occur when latching any of the plurality of the asynchronous outputs of the asynchronous logic circuit using said clock signal, and activates the stretch signal while the metastability could occur.

  17. Evaluation of the post-transfusion platelet increment and safety of riboflavin-based pathogen reduction technology (PRT) treated platelet products stored in platelet additive solution for 5 days or less versus 6-7 days.

    PubMed

    Kaplan, Alesia; Lindgren, Bruce; Marschner, Susanne; Aznar, Marivi; Zalba, Saioa; Sánchez, Piva; Ayape, María Luisa; Olavarría, Eduardo; Antelo, Maria Luisa

    2016-04-01

    Platelets are stored routinely for 5 days or less and extended platelet storage time could improve product availability. This study compared platelet count increments (CI24hs) of riboflavin plus UV-light (PRT) treated platelet products in platelet additive solution stored for 5 days or less to products stored for 6-7 days. This was a retrospective study comparing CI24hs between two groups. Hematology patients received PRT treated platelet products stored for <5 days, or for 6-7 days. Platelet counts and adverse events during and up to 24 hours after transfusion were recorded and compared between the groups. Ninety-seven patients received 168 transfusions of <5 day old PRT-treated platelets and 49 patients received 74 transfusions of 6-7 day old PRT-treated platelets. There was no statistically significant difference in CI24hs between the <5 day (median 6000) and 6-7 day storage group (median 8000) (p-value = 0.509). One mild fever was documented in the <5 day storage group. CI24hs are similar for PRT-treated PLTs stored in PAS for <5 or 6-7 days. Studies to further evaluate clinical outcomes such as bleeding are ongoing. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... not apply to closed ventilation systems for motors or generators, diffuser fans for refrigerated... 46 Shipping 4 2011-10-01 2011-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY...

  19. 46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... not apply to closed ventilation systems for motors or generators, diffuser fans for refrigerated... 46 Shipping 4 2010-10-01 2010-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY...

  20. 46 CFR 111.103-1 - Power ventilation systems except machinery space ventilation systems.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Power ventilation systems except machinery space ventilation systems. 111.103-1 Section 111.103-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Remote Stopping Systems § 111.103-1 Power ventilation systems except machinery...

  1. Microfluidic serial dilution circuit.

    PubMed

    Paegel, Brian M; Grover, William H; Skelley, Alison M; Mathies, Richard A; Joyce, Gerald F

    2006-11-01

    In vitro evolution of RNA molecules requires a method for executing many consecutive serial dilutions. To solve this problem, a microfluidic circuit has been fabricated in a three-layer glass-PDMS-glass device. The 400-nL serial dilution circuit contains five integrated membrane valves: three two-way valves arranged in a loop to drive cyclic mixing of the diluent and carryover, and two bus valves to control fluidic access to the circuit through input and output channels. By varying the valve placement in the circuit, carryover fractions from 0.04 to 0.2 were obtained. Each dilution process, which is composed of a diluent flush cycle followed by a mixing cycle, is carried out with no pipeting, and a sample volume of 400 nL is sufficient for conducting an arbitrary number of serial dilutions. Mixing is precisely controlled by changing the cyclic pumping rate, with a minimum mixing time of 22 s. This microfluidic circuit is generally applicable for integrating automated serial dilution and sample preparation in almost any microfluidic architecture.

  2. Passive continuous positive airway pressure ventilation during cardiopulmonary resuscitation: a randomized cross-over manikin simulation study.

    PubMed

    Winkler, Bernd E; Muellenbach, Ralf M; Wurmb, Thomas; Struck, Manuel F; Roewer, Norbert; Kranke, Peter

    2017-02-01

    While controlled ventilation is most frequently used during cardiopulmonary resuscitation (CPR), the application of continuous positive airway pressure (CPAP) and passive ventilation of the lung synchronously with chest compressions and decompressions might represent a promising alternative approach. One benefit of CPAP during CPR is the reduction of peak airway pressures and therefore a potential enhancement in haemodynamics. We therefore evaluated the tidal volumes and airway pressures achieved during CPAP-CPR. During CPR with the LUCAS™ 2 compression device, a manikin model was passively ventilated at CPAP levels of 5, 10, 20 and 30 hPa with the Boussignac tracheal tube and the ventilators Evita(®) V500, Medumat(®) Transport, Oxylator(®) EMX, Oxylog(®) 2000, Oxylog(®) 3000, Primus(®) and Servo(®)-i as well as the Wenoll(®) diver rescue system. Tidal volumes and airway pressures during CPAP-CPR were recorded and analyzed. Tidal volumes during CPAP-CPR were higher than during compression-only CPR without positive airway pressure. The passively generated tidal volumes increased with increasing CPAP levels and were significantly influenced by the ventilators used. During ventilation at 20 hPa CPAP via a tracheal tube, the mean tidal volumes ranged from 125 ml (Medumat(®)) to 309 ml (Wenoll(®)) and the peak airway pressures from 23 hPa (Primus(®)) to 49 hPa (Oxylog(®) 3000). Transport ventilators generated lower tidal volumes than intensive care ventilators or closed-circuit systems. Peak airway pressures during CPAP-CPR were lower than those during controlled ventilation CPR reported in literature. High peak airway pressures are known to limit the applicability of ventilation via facemask or via supraglottic airway devices and may adversely affect haemodynamics. Hence, the application of ventilators generating high tidal volumes with low peak airway pressures appears desirable during CPAP-CPR. The limited CPAP-CPR capabilities of transport

  3. [Evaluation of patient-ventilator synchrony of three new types of ventilators with pressure sunnort ventilation mode].

    PubMed

    Zhou, Juan; Wu, Hao; Cao, Desen

    2014-08-01

    Pressure-support ventilation (PSV) is a form of important ventilation mode. Patient-ventilator synchrony of pressure support ventilation can be divided into inspiration-triggered and expiration-triggered ones. Whether the ventilator can track the patient's inspiration and expiration very well or not is an important evaluating item of the performance of the ventilator. The ventilator should response to the patient's inspiration effort on time and deliver the air flow to the patient under various conditions, such as different patient's lung types and inspiration effort, etc. Similarly, the ventilator should be able to response to the patient's expiration action, and to decrease the patient lung's internal pressure rapidly. Using the Active Servo Lung (ASL5000) respiratory simulation system, we evaluated the spontaneous breathing of PSV mode on E5, Servo i and Evital XL. The following parameters, the delay time before flow to the patient starts once the trigger variable signaling the start of inspiration, the lowest inspiratory airway pressure generated prior to the initiation of PSV, etc. were measured.

  4. Estimating Locations of Perennial Streams in Idaho Using a Generalized Least-Squares Regression Model of 7-Day, 2-Year Low Flows

    USGS Publications Warehouse

    Wood, Molly S.; Rea, Alan; Skinner, Kenneth D.; Hortness, Jon E.

    2009-01-01

    Many State and Federal agencies use information regarding the locations of streams having intermittent or perennial flow when making management and regulatory decisions. For example, the application of some Idaho water quality standards depends on whether streams are intermittent. Idaho Administrative Code defines an intermittent stream as one having a 7-day, 2-year low flow (7Q2) less than 0.1 ft3/s. However, there is a general recognition that the cartographic representation of perennial/intermittent status of streams on U.S. Geological Survey (USGS) topographic maps is not as accurate or consistent as desirable from one map to another, which makes broad management and regulatory assessments difficult and inconsistent. To help resolve this problem, the USGS has developed a methodology for predicting the locations of perennial streams based on regional generalized least-squares (GLS) regression equations for Idaho streams for the 7Q2 low-flow statistic. Using these regression equations, the 7Q2 streamflow may be estimated for naturally flowing streams in most areas in Idaho. The use of these equations in conjunction with a geographic information system (GIS) technique known as weighted flow accumulation allows for an automated and continuous estimation of 7Q2 streamflow at all points along stream reaches. The USGS has developed a GIS-based map of the locations of streams in Idaho with perennial flow based on a 7Q2 of 0.1 ft3/s and a transition zone of plus or minus 1 standard error. Idaho State cooperators plan to use this information to make regulatory and water-quality management decisions. Originally, 7Q2 equations were developed for eight regions of similar hydrologic characteristics in the study area, using long-term data from 234 streamflow-gaging stations. Equations in five of the regions were revised based on spatial patterns observed in the initial perennial streams map and unrealistic behavior of the equations in extrapolation. The standard errors of

  5. Intermittent ventilation in the hypoxic zone of western Long Island Sound during the summer of 2004

    NASA Astrophysics Data System (ADS)

    O'Donnell, James; Dam, Hans G.; Bohlen, W. Frank; Fitzgerald, William; Gay, Peter S.; Houk, Adam E.; Cohen, David C.; Howard-Strobel, Mary M.

    2008-09-01

    Observations of dissolved oxygen (DO) concentration, salinity, and temperature, during summer of 2004, at three levels on two moorings in the area of western Long Island Sound that is prone to seasonal hypoxia are described. Ship surveys in the area reveal that the DO concentration below the pycnocline decreases at approximately 2.4 mM m-3 d-1 throughout the summer. We show that this is the net result of oscillations in the rate of change of the DO concentration with periods of 3 to 7 days. During intervals of declining DO concentration, the rate of change is consistent with previous estimates of the rate of community respiration. Since there is insufficient light for photosynthesis below the pycnocline, increasing DO concentration (ventilation) must be a consequence of either vertical mixing or horizontal advection from regions of higher concentration. Analysis of the covariation of DO, salinity, and temperature and knowledge of the mean property distributions allow us to associate most (˜80%) of the ventilation intervals with increased vertical mixing. Comparison of DO and wind stress measurements suggest that it is the component in the along-sound direction that controls the occurrence of ventilation, perhaps through modification of the rate of stratification by the density-driven circulation. We conclude that the spatial and temporal variability of vertical mixing is crucial to understanding the duration and extent of hypoxia in the Long Island Sound estuary.

  6. Alternative approaches to ventilator-associated pneumonia prevention.

    PubMed

    Berra, L; Sampson, J; Fumagalli, J; Panigada, M; Kolobow, T

    2011-03-01

    Ventilator-associated pneumonia (VAP), which develops in patients receiving mechanical ventilation, is the most common nosocomial infection in patients with acute respiratory failure. The major mechanism of lower respiratory tract colonization is aspiration of bacteria-colonized secretions from the oropharynx into the lower airways. The hydrostatic pressure of the secretions that collect in the subglottic space, which is the area above the endotracheal tube (ETT) cuff, or aerosolization of bacteria from the secretions collected within the respiratory tubing may facilitate the leakage into the lower airways. Ideally, the elimination of the mechanisms responsible for aspiration would decrease the incidence of VAP. Several preventive measures have been tested in clinical trials with little success.Here we present the results of our efforts to develop novel approaches for the prevention of VAP. Specifically, we found that keeping ventilated patients in a lateral position, which eliminates gravitational forces, is feasible and possibly advantageous. Additionally, several novel medical devices have been recently developed to prevent bacterial biofilm formation from the ETT and breathing tubing. These devices include coated ETTs, mucus shavers and mucus slurpers. Prevention of ETT bacterial colonization showed decreased bacterial colonization of the respiratory circuit and of the lower respiratory tract in laboratory studies and clinical trials. Future large studies should be designed to test the hypothesis that VAP can be prevented with these novel strategies. While there is a current focus on the use of respiratory devices to prevent biofilm formation and microaspiration, it is important to remember that lower respiratory tract colonization is multifactorial. Prevention of VAP cannot be achieved solely by eliminating bacterial biofilm on respiratory devices, and more comprehensive care of the intubated patient needs to be implemented.

  7. ELECTRONIC MULTIPLIER CIRCUIT

    DOEpatents

    Thomas, R.E.

    1959-08-25

    An electronic multiplier circuit is described in which an output voltage having an amplitude proportional to the product or quotient of the input signals is accomplished in a novel manner which facilitates simplicity of circuit construction and a high degree of accuracy in accomplishing the multiplying and dividing function. The circuit broadly comprises a multiplier tube in which the plate current is proportional to the voltage applied to a first control grid multiplied by the difference between voltage applied to a second control grid and the voltage applied to the first control grid. Means are provided to apply a first signal to be multiplied to the first control grid together with means for applying the sum of the first signal to be multiplied and a second signal to be multiplied to the second control grid whereby the plate current of the multiplier tube is proportional to the product of the first and second signals to be multiplied.

  8. Logsum Using Garbled Circuits

    PubMed Central

    Portêlo, José; Raj, Bhiksha; Trancoso, Isabel

    2015-01-01

    Secure multiparty computation allows for a set of users to evaluate a particular function over their inputs without revealing the information they possess to each other. Theoretically, this can be achieved using fully homomorphic encryption systems, but so far they remain in the realm of computational impracticability. An alternative is to consider secure function evaluation using homomorphic public-key cryptosystems or Garbled Circuits, the latter being a popular trend in recent times due to important breakthroughs. We propose a technique for computing the logsum operation using Garbled Circuits. This technique relies on replacing the logsum operation with an equivalent piecewise linear approximation, taking advantage of recent advances in efficient methods for both designing and implementing Garbled Circuits. We elaborate on how all the required blocks should be assembled in order to obtain small errors regarding the original logsum operation and very fast execution times. PMID:25811740

  9. ELECTRONIC TRIGGER CIRCUIT

    DOEpatents

    Russell, J.A.G.

    1958-01-01

    An electronic trigger circuit is described of the type where an output pulse is obtained only after an input voltage has cqualed or exceeded a selected reference voltage. In general, the invention comprises a source of direct current reference voltage in series with an impedance and a diode rectifying element. An input pulse of preselected amplitude causes the diode to conduct and develop a signal across the impedance. The signal is delivered to an amplifier where an output pulse is produced and part of the output is fed back in a positive manner to the diode so that the amplifier produces a steep wave front trigger pulsc at the output. The trigger point of the described circuit is not subject to variation due to the aging, etc., of multi-electrode tabes, since the diode circuit essentially determines the trigger point.

  10. ELECTRONIC PHASE CONTROL CIRCUIT

    DOEpatents

    Salisbury, J.D.; Klein, W.W.; Hansen, C.F.

    1959-04-21

    An electronic circuit is described for controlling the phase of radio frequency energy applied to a multicavity linear accelerator. In one application of the circuit two cavities are excited from a single radio frequency source, with one cavity directly coupled to the source and the other cavity coupled through a delay line of special construction. A phase detector provides a bipolar d-c output signal proportional to the difference in phase between the voltage in the two cavities. This d-c signal controls a bias supply which provides a d-c output for varying the capacitnce of voltage sensitive capacitors in the delay line. The over-all operation of the circuit is completely electronic, overcoming the time response limitations of the electromechanical control systems, and the relative phase relationship of the radio frequency voltages in the two caviiies is continuously controlled to effect particle acceleration.

  11. Targeting Neural Circuits.

    PubMed

    Rajasethupathy, Priyamvada; Ferenczi, Emily; Deisseroth, Karl

    2016-04-21

    Optogenetic methodology enables direct targeting of specific neural circuit elements for inhibition or excitation while spanning timescales from the acute (milliseconds) to the chronic (many days or more). Although the impact of this temporal versatility and cellular specificity has been greater for basic science than clinical research, it is natural to ask whether the dynamic patterns of neural circuit activity discovered to be causal in adaptive or maladaptive behaviors could become targets for treatment of neuropsychiatric diseases. Here, we consider the landscape of ideas related to therapeutic targeting of circuit dynamics. Specifically, we highlight optical, ultrasonic, and magnetic concepts for the targeted control of neural activity, preclinical/clinical discovery opportunities, and recently reported optogenetically guided clinical outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Measurement of respiratory mechanics using the Puritan-Bennett 7200a ventilator.

    PubMed

    Chartrand, D; Dionne, B; Jodoin, C; Lorange, M; Lapointe, A

    1993-11-01

    This study was designed in order to validate the respiratory mechanical variables measured by the Puritan-Bennett 7200a ventilator equipped with the 30/40 module. Two ventilators were connected to a lung model and submitted to several breathing patterns by modifying the respiratory rate, the tidal volume, the inspiratory flow-rate and the model resistance. The inspiratory flow-rate (V), tidal volume (VT), peak inspiratory pressure (Pmax), plateau pressure (Pplat) and PEEP measured by the ventilators were compared with the same variables measured at the connection between the breathing circuit and the lung model. The compliance (C30/40) and the resistance (R30/40) calculated by the 30/40 module were compared with those calculated by using the variables measured by the reference equipment. Both ventilators made a constant underestimation of V by 2.8 and 3.7 L.min-1, respectively. The VT was measured with a mean error of less than 10 ml but did not reflect the preselected values in the presence of an intrinsic PEEP. The Pplat was overestimated by 7 and 10%, respectively. The same calibration error was observed with Pmax which was also affected by a pressure gradient due to the resistance of the breathing circuit. Even in the absence of intrinsic PEEP, C30/40 presented an error due to the combination of the measurement errors on VT, Pplat and PEEP. Finally, R30/40 presented a high percentage of error due to the combination of the measurement errors on V, Pmax, and Pplat, and to a sporadic aberrant selection of V. Due to these numerous sources of error, the two ventilators studied did not give reliable estimates of resistance and compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Comparison of jet and ultrasonic nebulizer pulmonary aerosol deposition during mechanical ventilation.

    PubMed

    Harvey, C J; O'Doherty, M J; Page, C J; Thomas, S H; Nunan, T O; Treacher, D F

    1997-04-01

    Increased delivery of aerosol to a model lung (attached to a mechanical ventilator) has been demonstrated with an ultrasonic nebulizer as compared to a jet nebulizer. This study examined whether the increased aerosol deposition with an ultrasonic nebulizer could also be demonstrated in vivo. Seven patients (6 male and 1 female) were studied during mechanical ventilalion (Siemens Servo 900C, Middlesex, UK) after open heart surgery. Two studies were performed in each patient. In the first study, aerosol was delivered via a Siemens Servo 945 nebulizer system (high setting) driving a System 22 Acorn jet nebulizer (Medic-Aid, Sussex, UK) containing 3 mL (99m)technetium-labelled human serum albumin (99mTc-HSA) (50 microg; activity 74 MBq). In the second study, a DP100 ultrasonic nebulizer (DP Medical, Meylan, France) containing 12 mL 99mTc-HSA (50 microg; activity 185 MBq) was used. Pulmonary deposition was quantified using a gamma camera. The humidification of the circuit and the ventilator settings were kept constant according to the patient's clinical requirements. The total lung aerosol deposition (mean+/-SD), as a percentage of initial nebulizer activity, was greater using the ultrasonic nebulizer than using the jet nebulizer (53+/-1.4 vs 2.3+/-0.9%; p<0.002). The ultrasonic nebulizer was also associated with a reduction in the time required to complete nebulization (9 vs 21 min, respectively) (p<0.0001). Use of the DP100 ultrasonic nebulizer more than doubled lung deposition compared with the System 22 jet nebulizers in mechanically-ventilated patients. Their efficiency, speed of drug delivery, and compatibility with mechanical ventilator circuits make ultrasonic nebulizers potentially attractive for use during mechanical ventilation.

  14. Chaotic memristive circuit: equivalent circuit realization and dynamical analysis

    NASA Astrophysics Data System (ADS)

    Bao, Bo-Cheng; Xu, Jian-Ping; Zhou, Guo-Hua; Ma, Zheng-Hua; Zou, Ling

    2011-12-01

    In this paper, a practical equivalent circuit of an active flux-controlled memristor characterized by smooth piecewise-quadratic nonlinearity is designed and an experimental chaotic memristive circuit is implemented. The chaotic memristive circuit has an equilibrium set and its stability is dependent on the initial state of the memristor. The initial state-dependent and the circuit parameter-dependent dynamics of the chaotic memristive circuit are investigated via phase portraits, bifurcation diagrams and Lyapunov exponents. Both experimental and simulation results validate the proposed equivalent circuit realization of the active flux-controlled memristor.

  15. Ventilator-induced Lung Injury

    PubMed Central

    Kneyber, Martin C. J.; Zhang, Haibo; Slutsky, Arthur S.

    2016-01-01

    It is well established that mechanical ventilation can injure the lung, producing an entity known as ventilator-induced lung injury (VILI). There are various forms of VILI, including volutrauma (i.e., injury caused by overdistending the lung), atelectrauma (injury due to repeated opening/closing of lung units), and biotrauma (release of mediators that can induce lung injury or aggravate pre-existing injury, potentially leading to multiple organ failure). Experimental data in the pediatric context are in accord with the importance of VILI, and appear to show age-related susceptibility to VILI, although a conclusive link between use of large Vts and mortality has not been demonstrated in this population. The relevance of VILI in the pediatric intensive care unit population is thus unclear. Given the physiological and biological differences in the respiratory systems of infants, children, and adults, it is difficult to directly extrapolate clinical practice from adults to children. This Critical Care Perspective analyzes the relevance of VILI to the pediatric population, and addresses why pediatric patients might be less susceptible than adults to VILI. PMID:25003705

  16. Manual resuscitators and portable ventilators.

    PubMed

    Phillips, G D; Skowronski, G A

    1986-08-01

    This paper reviews the state of the art in Australia of manually operated, self-inflating bag resuscitators, including the Laerdal, Air Viva and Ambu; manually operated bags dependent upon an oxygen supply, including Mapleson B, C, E and F, the CIG Medishield Oxy-Saver and modified Oxy-Viva Resuscitator 3, and the Komesaroff Oxy-Resuscitator RD85; oxygen-powered resuscitators, including the Oxy-Viva Resuscitator 3 with Demand and RM2 Valves, and the Oxylife FM85; and portable ventilators, including the Drager Oxylog, and Ohmeda Logic 07. Specific comment is made to the effect that the design of the resuscitator is often less important than the knowledge and ability of the operator in using the equipment to achieve adequate lung ventilation. The simplest, cheapest, most useful resuscitators are the manually operated self-inflating bag assemblies. With special training, use of more complex equipment can be justified in some circumstances. The more complex the equipment, the greater the risk of inappropriate use, and the greater the risk of equipment malfunction unless a regular maintenance program is followed.

  17. Dynamic Behaviour of Ventilated Hydrofoils.

    NASA Astrophysics Data System (ADS)

    Kjeldsen, Morten; Arndt, Roger; Wosnik, Martin

    2006-11-01

    In certain types of pumping applications oscillations are induced by operation with liquids containing a free gas load. In order to understand the physics of this process, a series of tests with a ventilated A 2D NACA 0015 hydrofoil were performed in the water tunnel at the St. Anthony Falls Laboratory of the University of Minnesota. The special bubble removal feature of the water tunnel allowed continuous ventilation without experiencing visible bubbles upstream the hydrofoil. These studies build on previous work on cavitation-induced oscillations. Gas injection studies were made over a range of gas flow rates and test section pressure. The results clearly show that lift oscillations increase in intensity when the gas load is increased. The point of maximum unsteadiness is also associated the rapid decline of the foil performance as measured as average lift. Further increase of the gas injection load gives a steady behaviour with almost no lift. These experiments are compared with traditional cavitation experiments. The similarities between gas injection- and cavitation induced unsteadiness on the hydrofoil are many, but the amplitude of lift oscillations found on the foil with gas injection corresponds to about 50% of that found for cavitating hydrofoils. The fact that the oscillations are periodic leads to the consideration of both passive and active control.

  18. Small circuits for cryptography.

    SciTech Connect

    Torgerson, Mark Dolan; Draelos, Timothy John; Schroeppel, Richard Crabtree; Miller, Russell D.; Anderson, William Erik

    2005-10-01

    This report examines a number of hardware circuit design issues associated with implementing certain functions in FPGA and ASIC technologies. Here we show circuit designs for AES and SHA-1 that have an extremely small hardware footprint, yet show reasonably good performance characteristics as compared to the state of the art designs found in the literature. Our AES performance numbers are fueled by an optimized composite field S-box design for the Stratix chipset. Our SHA-1 designs use register packing and feedback functionalities of the Stratix LE, which reduce the logic element usage by as much as 72% as compared to other SHA-1 designs.

  19. Micromachined Silicon Waveguide Circuits

    NASA Technical Reports Server (NTRS)

    McGrath, W. R.

    1995-01-01

    Rectangular waveguides are commonly used as circuit elements in remote-sensing heterodyne receivers at millimeter wavelengths. The advantages of waveguides are low loss and mechanical tunability. However, conventional machining techniques for waveguide components operating above a few hundred GHz are complicated and costly. Waveguides micromachined from silicon however would have several important advantages including low-cost; small size for very high frequency (submillimeter wave) operation; high dimensional accuracy (important for high-Q circuits); atomically smooth walls, thereby reducing rf losses; and the ability to integrate active and passive devices directly in the waveguide on thin membranes, thereby solving the traditional problem of mounting thin substrates.

  20. Electrical Circuit Tester

    DOEpatents

    Love, Frank

    2006-04-18

    An electrical circuit testing device is provided, comprising a case, a digital voltage level testing circuit with a display means, a switch to initiate measurement using the device, a non-shorting switching means for selecting pre-determined electrical wiring configurations to be tested in an outlet, a terminal block, a five-pole electrical plug mounted on the case surface and a set of adapters that can be used for various multiple-pronged electrical outlet configurations for voltages from 100 600 VAC from 50 100 Hz.